Phase 1/2 Study of Synchronous Methotrexate, Cisplatin, Vincristine (MOPq10) Chemotherapy and Radiation for Patients with Locally Advanced Bladder Cancer

Abstract

Purpose: This phase 1/2 study was designed to test toxicity and effectiveness of combination chemotherapy and concurrent radiotherapy in the treatment of invasive bladder cancer. Methods and Materials: 17 patients with localised muscle-invasive bladder cancer, clinical stages T2–3 N0, M0, were treated with a radiotherapy schedule of 55 Gy in 20 fractions over 4 weeks restricted to the bladder and 3 cycles of concurrent dose-intensive combination chemotherapy consisting of cisplatin 60 mg/m², vincristine 2 mg and methotrexate 60 mg/m² at 10-day intervals (MOPq10). Results: The complete remission rate following MOPq10 chemotherapy and radiotherapy was 88% as assessed at first cystoscopy with 82% remaining disease-free at 1 year. Risk factor analysis shows those older than 63 years (median) and those with creatinine clearance equal or less than the mean did worse. Actuarial disease-free survival at 2 years was 68% and of the patients treated 4/17 experienced acute G3/4 toxicity. Conclusion: This combination regimen was feasible. Its high initial response rate justifies further exploration in a randomised phase 2/3 trial setting with bladder volume and quality of life assessment.

Beyond Benford's Law: Distinguishing Noise from Chaos

“…The crucial difference between the current approach and the symbolic method propose in reference [ 13 ] is that we symbolize the time series by the first digits but the reported multi-scale permutation entropy approach [ 13 ] symbolize the time series through comparing the neighbor values in specifically dimensional ordinal pattern. Although a successful explanation of BL has remained elusive [ 22 – 26 ], some basic properties are clear for Benford's law. It has been proven that BL represents the only probability distribution which is both scale and base invariant [ 27 , 28 ].…”

Natural Phytochemicals in Bladder Cancer Prevention and Therapy

“…Goonewardene carried out a phase I/II clinical study using vincristine combined with methotrexate and cisplatin. This clinical trial result showed that vincristine combined chemotherapy significantly prolonged the survival period of invasive bladder cancer patients (92). The neoadjuvant cisplatin, methotrexate, and vinblastine (CMV) chemotherapy in muscle-invasive bladder cancer patients was studied in a randomized phase III trial.…”