Efficacy of Dose-intensified MEC (Methotrexate, Epirubicin and Cisplatin) Chemotherapy for Advanced Urothelial Carcinoma

A Prospective Randomized Trial Comparing MEC and M-VAC (Methotrexate, Vinblastine, Doxorubicin and Cisplatin)

Masao Kuroda, Toshihiko Kotake, Hideyuki Akaza, Shiro Hinotsu, Tadao Kakizoe

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Abstract

Background: To evaluate the antitumor activity in patients with T3b, T4 or metastatic urothelial carcinoma treated with MEC or M-VAC chemotherapy, by performing a multi-center randomized prospective study. Methods: From 1991 to 1995, 89 patients with T3b, T4 or metastatic urothelial carcinoma were randomly allocated to a methotrexate, epirubicin and cisplatin chemotherapy group (arm 1: S-MEC therapy; n = 29), a dose-intensified MEC therapy combined with G-CSF group (arm 2: I-MEC therapy; n = 30) or a methotrexate, vinblastine, doxorubicin and cisplatin chemotherapy (arm 3: M-VAC therapy; n = 30). At the registration center, the patients were stratified into previously untreated patients and patients with recurrence after radical operation and then randomly allocated to the treatment groups. In each arm, two or more courses of chemotherapy (4-week cycles) were performed. Results: Of the 88 eligible patients, four treated with S-MEC therapy and two treated with I-MEC therapy showed CR. The response rates (CR + PR) were 52% (15/29) with S-MEC therapy, 76% (22/29) with I-MEC therapy and 47% (14/30) with M-VAC therapy. The response rate with I-MEC therapy was significantly higher than that with M-VAC therapy (P = 0.02). Although the incidence of leukopenia was low with I-MEC therapy, the incidence of thrombocytopenia was high with this therapy. Conclusion: MEC therapy used in this study is promising in terms of the antitumor effects.

Original languageEnglish
Pages (from-to)497-501
Number of pages5
JournalJapanese Journal of Clinical Oncology
Volume28
Issue number8
Publication statusPublished - 1998
Externally publishedYes

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Epirubicin
Vinblastine
Methotrexate
Doxorubicin
Cisplatin
Carcinoma
Drug Therapy
Therapeutics
Incidence
Leukopenia
Granulocyte Colony-Stimulating Factor

Keywords

  • Advanced urothelial carcinoma
  • Chemotherapy

ASJC Scopus subject areas

  • Oncology

Cite this

@article{0a7787d234e344c1be6cd5403c7ec707,
title = "Efficacy of Dose-intensified MEC (Methotrexate, Epirubicin and Cisplatin) Chemotherapy for Advanced Urothelial Carcinoma: A Prospective Randomized Trial Comparing MEC and M-VAC (Methotrexate, Vinblastine, Doxorubicin and Cisplatin)",
abstract = "Background: To evaluate the antitumor activity in patients with T3b, T4 or metastatic urothelial carcinoma treated with MEC or M-VAC chemotherapy, by performing a multi-center randomized prospective study. Methods: From 1991 to 1995, 89 patients with T3b, T4 or metastatic urothelial carcinoma were randomly allocated to a methotrexate, epirubicin and cisplatin chemotherapy group (arm 1: S-MEC therapy; n = 29), a dose-intensified MEC therapy combined with G-CSF group (arm 2: I-MEC therapy; n = 30) or a methotrexate, vinblastine, doxorubicin and cisplatin chemotherapy (arm 3: M-VAC therapy; n = 30). At the registration center, the patients were stratified into previously untreated patients and patients with recurrence after radical operation and then randomly allocated to the treatment groups. In each arm, two or more courses of chemotherapy (4-week cycles) were performed. Results: Of the 88 eligible patients, four treated with S-MEC therapy and two treated with I-MEC therapy showed CR. The response rates (CR + PR) were 52{\%} (15/29) with S-MEC therapy, 76{\%} (22/29) with I-MEC therapy and 47{\%} (14/30) with M-VAC therapy. The response rate with I-MEC therapy was significantly higher than that with M-VAC therapy (P = 0.02). Although the incidence of leukopenia was low with I-MEC therapy, the incidence of thrombocytopenia was high with this therapy. Conclusion: MEC therapy used in this study is promising in terms of the antitumor effects.",
keywords = "Advanced urothelial carcinoma, Chemotherapy",
author = "Masao Kuroda and Toshihiko Kotake and Hideyuki Akaza and Shiro Hinotsu and Tadao Kakizoe",
year = "1998",
language = "English",
volume = "28",
pages = "497--501",
journal = "Japanese Journal of Clinical Oncology",
issn = "0368-2811",
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number = "8",

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TY - JOUR

T1 - Efficacy of Dose-intensified MEC (Methotrexate, Epirubicin and Cisplatin) Chemotherapy for Advanced Urothelial Carcinoma

T2 - A Prospective Randomized Trial Comparing MEC and M-VAC (Methotrexate, Vinblastine, Doxorubicin and Cisplatin)

AU - Kuroda, Masao

AU - Kotake, Toshihiko

AU - Akaza, Hideyuki

AU - Hinotsu, Shiro

AU - Kakizoe, Tadao

PY - 1998

Y1 - 1998

N2 - Background: To evaluate the antitumor activity in patients with T3b, T4 or metastatic urothelial carcinoma treated with MEC or M-VAC chemotherapy, by performing a multi-center randomized prospective study. Methods: From 1991 to 1995, 89 patients with T3b, T4 or metastatic urothelial carcinoma were randomly allocated to a methotrexate, epirubicin and cisplatin chemotherapy group (arm 1: S-MEC therapy; n = 29), a dose-intensified MEC therapy combined with G-CSF group (arm 2: I-MEC therapy; n = 30) or a methotrexate, vinblastine, doxorubicin and cisplatin chemotherapy (arm 3: M-VAC therapy; n = 30). At the registration center, the patients were stratified into previously untreated patients and patients with recurrence after radical operation and then randomly allocated to the treatment groups. In each arm, two or more courses of chemotherapy (4-week cycles) were performed. Results: Of the 88 eligible patients, four treated with S-MEC therapy and two treated with I-MEC therapy showed CR. The response rates (CR + PR) were 52% (15/29) with S-MEC therapy, 76% (22/29) with I-MEC therapy and 47% (14/30) with M-VAC therapy. The response rate with I-MEC therapy was significantly higher than that with M-VAC therapy (P = 0.02). Although the incidence of leukopenia was low with I-MEC therapy, the incidence of thrombocytopenia was high with this therapy. Conclusion: MEC therapy used in this study is promising in terms of the antitumor effects.

AB - Background: To evaluate the antitumor activity in patients with T3b, T4 or metastatic urothelial carcinoma treated with MEC or M-VAC chemotherapy, by performing a multi-center randomized prospective study. Methods: From 1991 to 1995, 89 patients with T3b, T4 or metastatic urothelial carcinoma were randomly allocated to a methotrexate, epirubicin and cisplatin chemotherapy group (arm 1: S-MEC therapy; n = 29), a dose-intensified MEC therapy combined with G-CSF group (arm 2: I-MEC therapy; n = 30) or a methotrexate, vinblastine, doxorubicin and cisplatin chemotherapy (arm 3: M-VAC therapy; n = 30). At the registration center, the patients were stratified into previously untreated patients and patients with recurrence after radical operation and then randomly allocated to the treatment groups. In each arm, two or more courses of chemotherapy (4-week cycles) were performed. Results: Of the 88 eligible patients, four treated with S-MEC therapy and two treated with I-MEC therapy showed CR. The response rates (CR + PR) were 52% (15/29) with S-MEC therapy, 76% (22/29) with I-MEC therapy and 47% (14/30) with M-VAC therapy. The response rate with I-MEC therapy was significantly higher than that with M-VAC therapy (P = 0.02). Although the incidence of leukopenia was low with I-MEC therapy, the incidence of thrombocytopenia was high with this therapy. Conclusion: MEC therapy used in this study is promising in terms of the antitumor effects.

KW - Advanced urothelial carcinoma

KW - Chemotherapy

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M3 - Article

VL - 28

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JO - Japanese Journal of Clinical Oncology

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SN - 0368-2811

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