Cancer Res Treat.  2014 Apr;46(2):172-177.

Modified MVAC as a Second-Line Treatment for Patients with Metastatic Urothelial Carcinoma after Failure of Gemcitabine and Cisplatin Treatment

• Lee JH
• Kang SG
• Kim ST
• Kang SH
• Choi IK
• Park YJ
• Oh SC
• Sung DJ
• Seo JH
• Cheon J
• Shin SW
• Kim YH
• Kim JS
• Park KH

Abstract

PURPOSE
There is no established standard second-line chemotherapy for patients with advanced or metastatic urothelial carcinoma (UC) who failed gemcitabine and cisplatin (GC) chemotherapy. This study was conducted in order to investigate the efficacy and toxicity of modified methotrexate, vinblastine, doxorubicin, and cisplatin (MVAC) in patients with metastatic UC previously treated with GC.
MATERIALS AND METHODS
We retrospectively analyzed 28 patients who received modified MVAC between November 2004 and November 2012. All patients failed prior, first-line GC chemotherapy.
RESULTS
The median age of patients was 64.0 years (range, 33.0 to 77.0 years), and 23 (82.1%) patients had an Eastern Cooperative Oncology Group performance status of 0 or 1. The overall response rate and the disease control rate were 36.0% and 64.0%, respectively. After a median follow-up period of 38 weeks (range, 5 to 182 weeks), median progression free survival was 21.0 weeks (95% confidence interval [CI], 6.3 to 35.7 weeks) and median overall survival was 49.0 weeks (95% CI, 18.8 to 79.3 weeks). Grade 3 or 4 hematological toxicities included neutropenia (n=21, 75.0%) and anemia (n=9, 32.1%). Grade 3 or 4 non-hematological toxicities did not occur and there was no treatment-related death.
CONCLUSION
Modified MVAC appears to be a safe and active chemotherapy regimen in patients with stable physical status and adequate renal function after GC treatment.

Keyword

Urothelial carcinoma; M-VAC protocol; Second-line; Cisplatin failure

MeSH Terms

Anemia
Cisplatin*
Disease-Free Survival
Doxorubicin
Drug Therapy
Follow-Up Studies
Humans
Methotrexate
Neutropenia
Retrospective Studies
Vinblastine
Cisplatin
Doxorubicin
Methotrexate
Vinblastine

Figure

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  Fig. 1 Kaplan-Meier curve for overall survival.

• 

  Fig. 2 Kaplan-Meier curve for progression-free survival.

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