Ahmed Abd El-Warith, professor, oncology divison, Cairo University in Cairo, Egypt, and associates treated 30 patients with an intravenous combination of cisplatinum 80 mg/m² on day 1 and vinorelbine 30 mg/m² on days 1 and 8. The regimen was repeated every 3 weeks for a total of 3 cycles.

Subjects had locally advanced urinary bladder carcinoma: T4, NO, N1 and MO and a performance status no greater than 2.

Overall, 36.7% patients had a partial treatment response, and 10% patients had stable disease. While 3 (10%) patients become operable and had a radical cystectomy that confirmed the down-staging of their tumor, none of them had a pathological complete response.

Patients with transitional cell carcinoma showed a better response (7/16 = 43.7%) than patients with squamous cell carcinoma (4/14=28.5%).

There was no grade 3 or 4 nonhematologic toxicity except for nausea and vomiting in 3 (10%) patients. Grade 3 neutropenia occurred in 1 patient.

"Our study shows that the vinorelbine/cisplatinum combination in locally advanced bladder cancer produced a response rate that was more or less equal to the standard MVAC therapy [methotrexate; vinblastine; adriamycin; cisplatin] and to other drugs used in bladder cancer but with fewer side effects," Dr. Abd El-Warith observed in his presentation on February 8^th.

"It is important to note that 47% of patients in our series had squamous cell carcinoma, which is more resistant to chemotherapy," he said.

He also said that he was encouraged by the finding that with only 3 treatment cycles and without the addition of radiotherapy, 10% of patients become operable.

"This result confirms the effectiveness of the regimen," he added.

Finally, he emphasized that the optimal use of this combination in neoadjuvant therapy of locally advanced urinary bladder cancer and its concomitant use with radiotherapy requires further study.

Bladder cancer is the most common malignancy in Egypt, accounting for 30% of all cancers. About one fourth of patients have locally advanced inoperable tumors at the time of presentation.


[Presentation title: A Phase II Study of Neo-Adjuvant Vinorelbine/Cisplatinum Chemotherapy Combination in Locally Advanced Bladder Cancer. Abstract 196]

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