Long-Term Survival Results of a Randomized Trial Comparing Gemcitabine Plus Cisplatin, With Methotrexate, Vinblastine, Doxorubicin, Plus Cisplatin in Patients With Bladder Cancer

Abstract

Long-term overall and progression-free survival after treatment with GC or MVAC are similar. These results strengthen the role of GC as a standard of care in patients with locally advanced or metastatic TCC.

Monotherapy with Intravenous Vinflunine in Patients with Advanced or Metastatic Urothelial Cancer after Failure of a Platinum-Containing Regimen: A Retrospective Analysis of German Routine Data

“…Classified as a chemosensitive tumor, chemotherapy plays an important role in the treatment of advanced stages [3,4,5,6]. Usually cisplatin-containing combination chemotherapy with gemcitabine or MVAC (methotrexate, vinblastine, Adriamycin and cisplatin) is used as first-line treatment if patients are ‘fit' enough to tolerate cisplatin [4,7,8,9,10]. Alternatively, patients unlikely to tolerate this regimen may be palliated with a carboplatin-based regimen, other single-agent regimens or best supportive care (BSC) [10,11,12].…”

Uptake of neoadjuvant chemotherapy for invasive bladder cancer

“…Gemcitabine plus cisplatin (GC) has been commonly used in the neoadjuvant setting, as in the study by El-Gehani and colleagues, 5 8 Since GC was associated with significantly less toxicity, there has been an active push towards substituting MVAC with GC, even in the neoadjuvant setting. However, it remains unclear whether GC efficacy is similar to MVAC in the non-metastatic setting where the objective is cure rather than palliation.…”

What about Treatment of Metastatic Bladder Cancer

“…This regimen was advanced to a phase III trial comparing it with MVAC in 405 patients with stage IV UC [11]. Both arms had similar RRs (46%-49%) and OS (13.8-14.8 months), with improved toxicity profile in the GC arm.…”