PHASE-II TRIAL WITH CISPLATIN, DOXORUBICIN, AND CYCLOPHOSPHAMIDE (CAP) IN THE TREATMENT OF UROTHELIAL TRANSITIONAL CELL-CARCINOMA

Abstract

Patients with advanced transitional cell cancer of the bladder, urethra or renal pelvis were treated with a combination of cyclophosphamide, doxorubicin and cisplatin. Fifteen patients were evaluated, 12 of whom had cancer of the urinary bladder. Metastatic sites were bone (47% of the patients), lung (33%), pelvis (27%), liver (20%), nodes (7%) and brain (7%). Only 2 patients (13%) achieved a partial response (in measurable node and lung lesions) and survived 16 and 58 wk, Three patients (20%) had minor responses (in measurable bone, pelvic mass and bone and local lesions) and survived 8, 28 and 102+ wk, respectively. Four patients had stable disease and 6 had disease progression, with a median survival of 4 wk. Overall toxic effects were leukopenia (53% of the patients), thrombocytopenia (27%), nausea and vomiting (67%), alopecia (60%) and renal toxicity (13%). The response rate to the combination of cyclophosphamide, doxorubicin and cisplatin in transitional cell cancer of the urothelium apparently was not superior to the reported response rate to a single agent (e.g., cisplatin) and toxicity was greater.