Bladder Cancer
Conditions
Keywords
recurrent bladder cancer, stage II bladder cancer, stage III bladder cancer, stage IV bladder cancer
Brief summary
RATIONALE: Drugs used in chemotherapy, such as methotrexate, vinblastine, doxorubicin, and cisplatin, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving more than one drug (combination chemotherapy) may kill more tumor cells. Evaluating blood or tissue samples from patients with cancer may help doctors learn more about changes that occur in DNA, identify biomarkers related to cancer, and predict how well patients will respond to combination chemotherapy. PURPOSE: This phase II trial is studying gene expression profiling to see how well it works in predicting response to treatment in patients with invasive bladder cancer receiving methotrexate, vinblastine, doxorubicin, and cisplatin.
Detailed description
OBJECTIVES: Primary * Analyze the correlation between gene expression profile and the effect of chemotherapy and detect the significant cluster of genes useful to predict chemosensitivity. * Confirm the reduction in original tumor size in patients with invasive bladder cancer treated with methotrexate, vinblastine, doxorubicin hydrochloride, and cisplatin. Secondary * Determine the safety of this regimen in these patients. * Determine the overall survival rate in patients treated with this regimen. * Assess the reduction in size of metastatic lesions in patients treated with this regimen. OUTLINE: This is a multicenter study. Patients receive methotrexate on days 1, 15, and 22, vinblastine on days 2, 15, and 22, doxorubicin hydrochloride and cisplatin on day 2. Treatment repeats every 4 weeks in the absence of disease progression or unacceptable toxicity. Patient samples will be collected for gene expression profiling. After completion of study treatment, patients are followed for 3 years.
Interventions
DRUGcisplatin
DRUGdoxorubicin hydrochloride
DRUGmethotrexate
DRUGvinblastine
GENETICgene expression profiling
PROCEDUREneoadjuvant therapy
Sponsors
Kyoto University
Study design
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
20 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
DISEASE CHARACTERISTICS: * Diagnosis of invasive bladder cancer * Must be confirmed by chest and abdominal CT scan OR pelvic MRI scan and transurethral biopsy (with definitive muscle invasion \> T2) within 4 weeks prior to registration PATIENT CHARACTERISTICS: * ECOG performance status 0-1 * WBC ≥ 3,000/mm\^3 * Neutrophil count ≥ 1,500/mm\^3 * Platelet count ≥ 100,000/mm\^3 * Total bilirubin ≤ 1.5 mg/dL * Serum creatinine ≤ 1.5 mg/dL * AST and ALT ≤ 2.5 x upper limit of normal * Not pregnant * No liver cirrhosis * No ischemic cardiovascular disease or arrhythmia for which treatment is necessary * No cardiac infarction within the past 6 months * No interstitial pneumonia, pulmonary fibrosis, or any other diseases by which oxygen inhalation therapy is needed * No active cancerous lesion other than upper urinary tract tumor * No high fever or any other infectious symptom * No uncontrolled hypertension or diabetes mellitus PRIOR CONCURRENT THERAPY: * No prior systemic chemotherapy
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Detection of genes associated with sensitivity to the chemotherapy in tumor size reduction of original bladder tumor | — |
Secondary
| Measure | Time frame |
|---|---|
| Safety | — |
| Overall survival rate | — |
| Size reduction of metastatic lesion | — |
Countries
Japan
Outcome results
None listed