Which is Best Chemotherapy Option for Advanced Bladder Cancer?

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Transitional cell or urothelial carcinoma is the most common type of bladder cancer, accounting for more than 90% all bladder cancers.  This type of cancer is sensitive to treatment with chemotherapeutic agents.  

This type of cancer is usually treated with cisplatin-based chemotherapies such as methotreaxate, vinblastine, doxorubicin, and cisplatin (MVAC) and gemcitabine plus cisplatin.  Based on clinical trial results, 50%-60% of patients treated these agents can achieve objective responses and 10%-20% can achieve complete responses. 

However, not all patients can receive cisplatin-based chemotherapy.  For patients who have impaired renal function and other co-morbidities, carboplatin-based regimens are frequently utilized. 

Since there was no comparison on the effectiveness of the two regimens (cisplatin- versus carboplatin-based chemotherapy), an analysis was carried out. 

In the analysis, a total of 286 patients with metastatic UC from four randomized trials were included and their responses to the therapeutic treatments were analyzed.  

The investigators found that cisplatin-based chemotherapy was associated with a significantly higher likelihood of achieving a complete responses and overall responses (2.54 times and 34% higher in achieving complete and overall responses respectively) than carboplatin-based chemotherapy.  

This analysis concluded that cisplatin-based chemotherapy is superior to carboplatin-based, chemotherapy in achieving overall and complete responses in patients with metastatic urothelial cancers. 


Complete response was defined as the disappearance of all signs of cancer in response to treatment.   

Partial response was defined as a decrease in the size of a tumor, or in the extent of cancer in the body, in response to treatment.  

Overall response = complete response + partial response. 

Source: Annals of Advance Oncology, May 4, 2011. 

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