A Trial of Bleomycin versus Adriamycin in Advanced Carcinoma of the Bladder

Abstract

Thirty-seven patients were studied in a controlled clinical trial to assess the value of Adriamycin and Bleomycin in the treatment of advanced carcinoma of the bladder. The previously reported high response rates for both drugs were not observed in this trial. Administration of Bleomycin was accompanied by a toxicity rate so high that treatment had to be abandoned. Neither Adriamycin nor Bleomycin, therefore, used as single agents, have a role in the chemotherapy of advanced bladder cancer. Other agents should be investigated and assessed by controlled clinical trials that are disease-orientated rather than drug-orientated.

Advanced transitional cell bladder cancer: A treatable disease

“…A careful review of these studies reveals that the variability in response rates may be related to different doses of doxorubicin. Higher doxorubicin doses of between 60 and 75 mg/m2 have led to much higher response rates than lower doses [ 10, 25,28]. Other anthracycline derivatives like daunorubicin or mitoxanthrone have not been used in large enough series to accurately gauge their activity.…”

“…Considerable neurotoxicity was noted at a dose of 1 mg/m*/week after 8 weeks of treatment. This report phyllotoxin derivatives VM-26 (teniposide), and VP-16-213 (etoposide); neocarsinostatin, bleomycin [25], and the nitrosoureas [43]. Claims that VM26, VP-16 and neocarcinostatin are active drugs in TCCB [44] could not be substantiated by the Eastern Cooperative Oncology Group (ECOG) studies [45][46][47].…”

Adjuvant Chemotherapy in Bladder Cancer

“…A dose of 50-80 mg adriamycin will produce complete or partial remission of superficial tumours in approximately two-thirds of patients. In reviewing drugs active when used systemically for patients with advanced local or metastatic disease, he commented on the variable response rates reported for adriamycin (Middleman et al 1971,O'Bryan et al 1973, Tan et al 1973, Turner et al 1979, Yagoda 1980 which may be dose related (O'Bryan et al 1977), and for bleomycin (Pavone-Macaluso 1976, Turner et al 1979.…”

Soft-Agar Cultures of Transitional Cell Carcinoma Colonies from Urine, Irrigation Fluids and Tumor Samples

“…For advanced disease a truly effective chemotherapeutic regimen has not yet been developed. Cisplatin, as a single agent or in combi nation, is under investigation as are other drugs and com binations [Merrin et al, 1975;Cross et al, 1976;Yagoda et al, 1977Yagoda et al, , 1978Turner et al, 1979]. These regimens are not without risks and toxic side effects are usually dose-limiting.…”