Systemic Chemotherapy for Advanced Bladder Carcinoma: Clinical and Experimental Results

Summary:

The influence of systemic chemotherapy on advanced bladder carcinoma is limited. Apparently patients do not benefit from cytostatic treatment prior to surgical removal of the bladder (neoadjuvant chemotherapy). Combination chemotherapy subsequent to radical cystectomy is currently being investigated in several clinical trials; at present, however, adjuvant chemotherapy cannot be regarded as standard treatment. In metastatic disease, responses following application of cisplatin and methotrexate were observed in approximately 50 % of the patients without significantly influencing cure. Regarding the progress in surgical techniques including continent urinary diversion, improvement of chemotherapy through basic resarch and development of new cytotoxic agents and novel combination regimens is mandatory. We present the results of two clinical phase-II-trials with mitomycin C, 5-fluorouracil, and folinic acid as well as taxol, carboplatin, and acellular pertussis vaccine for cisplatin and methotrexate refractory metastatic bladder carcinoma.

Key words:

Bladder carcinoma - Systemic chemotherapy - Second-line chemotherapy