Induction chemotherapy with Methotrexate, Vinblastine, Epiadriamycin and Carboplatin (M-VEP) in transitional cell urothelial cancer

Radical cystectomy remains the standard treatment for patients with transitional cell urothelial carcinoma (TUCC) of the bladder with muscle invasion and/or N 0–2. However, 70–80% of these patients eventually die of disseminated disease. Systemic treatment might eradicate co-existing metastases [1]. Cisplatin, Methotrexate, Fluorouracil, Vinblastine, Mitomycin and Carboplatin have been used as single agents in metastatic disease, with 20–35% overall response (OR) being reported. Combinations including Cisplatin yield a relatively high OR (45–70%) and complete response (CR) rate. A 75% OR with 35% CR was reported with the M-VAC (Methotrexate, Vinblastine, Adriamycin, Cisplatin) regimen [2, 3].