Back to Journals » Research and Reports in Urology » Volume 2

Efficacy of methotrexate/vinblastine/doxorubicin/cisplatin combination in gemcitabine-pretreated patients with advanced urothelial cancer: a retrospective analysis

Authors Karadimou A, Lianos E, Pectasides D, Dimopoulos MA, Bamias A 

Published 6 December 2010 Volume 2010:2 Pages 193—199


Review by Single anonymous peer review

Peer reviewer comments 2

Alexandra Karadimou1, Evangelos Lianos1, Dimitrios Pectasides2, Meletios A Dimopoulos1, Aristotle Bamias1
1Department of Clinical Therapeutics, 2Second Department of Internal Medicine, University of Athens, Medical School, Greece

Objective: Second-line treatment options in advanced urothelial cancer are limited. We investigated the efficacy of a methotrexate/vinblastine/doxorubicin/cisplatin (MVAC) combination after failure of gemcitabine/platinum chemotherapy.
Patients and methods: Twenty-five patients with advanced urothelial cancer, who received second-line MVAC after first-line gemcitabine/cisplatin (n = 9) or gemcitabine/carboplatin (n = 16), were included in this retrospective analysis.
Results: Twenty-two patients (88%) relapsed within 6 months after first-line treatment. Following MVAC, there were 5 (20%) objective responses. Median follow-up was 20.2 months. Median progression-free survival (PFS) was 3.8 months (95% CI: 2.3–5.2), and median overall survival (OS) was 9 months (95% CI: 6.6–11.4). Eastern Cooperative Oncology Group performance status 0.1 versus 2 was associated with longer PFS (5 months versus 3.3 months, P = 0.049). Response or stabilization of disease during second-line chemotherapy predicted for a significantly longer PFS and OS (7.4 versus 3.5, P = 0.005; 15.5 versus 7, P = 0.046).
Conclusions: Second-line MVAC chemotherapy may result in prolonged survival in some patients with refractory disease. Further research in this field is necessary.

Keywords: MVAC, second line, bladder cancer

Creative Commons License © 2010 The Author(s). This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.