4B951, Combination Chemotherapy in Treating Patients With Bladder Cancer
Bladder Cancer
About this trial
This is an interventional treatment trial for Bladder Cancer focused on measuring stage I bladder cancer, stage II bladder cancer, transitional cell carcinoma of the bladder
Eligibility Criteria
DISEASE CHARACTERISTICS: Histologically proven organ confined transitional cell carcinoma (TCC) of the bladder Must have undergone radical cystectomy and bilateral pelvic lymphadenectomy with pathologic stage from definitive cystectomy specimen of P1, P2a, or P2b and N0, M0 TCC with or without squamous/glandular differentiation (no adenocarcinoma, squamous cell carcinoma, or small cell carcinoma) Margins must be negative for invasive or in situ TCC In situ TCC in the urethra or ureter(s) allowed provided margins are negative Clinical stage T1, T2a, or T2b based on transurethral resection bladder tumor specimen with P0 or PIS and N0, M0 TCC allowed Incidental pT2a (Gleason score no greater than 7), pT2b (Gleason score no greater than 7), or pT2c (Gleason score no greater than 7) adenocarcinoma of the prostate allowed No invasive tumor into ureter(s) or urethra Must have potentially curable disease Must register within 9 weeks after surgery No metastatic disease by physical exam and chest x-ray or CT scan of the chest Eligible for randomization if: p53 gene alteration present Randomization occurs within 10 weeks after surgery Those who are randomized to receive (MVAC) methotrexate, vinblastine, doxorubicin, and cisplatin begin MVAC within 12 weeks after cystectomy No metastatic disease by physical exam and chest x-ray or CT scan of the chest No prohibitive medical risk for chemotherapy PATIENT CHARACTERISTICS: Age Any age Performance status ECOG 0-1 OR Karnofsky 70-100% Life expectancy Not specified Hematopoietic WBC at least 4,000/mm^3 Platelet count at least 150,000/mm^3 Hepatic SGOT or SGPT no greater than 2 times normal Alkaline phosphatase no greater than 2 times normal Bilirubin normal Renal Creatinine no greater than 1.8 mg/dL OR Creatinine clearance at least 50 mL/min Blood urea nitrogen normal Cardiovascular No serious arrhythmias No congestive heart disease with New York Heart Association class III or IV status Randomization group: Ejection fraction must be at least 50% by MUGA scan if there is a clinical concern regarding the patient's cardiac status Other No other malignancy (including synchronous papillary or invasive upper urinary tract malignancy) within the past 5 years except incidental prostate cancer (found at cystectomy), basal cell or squamous cell skin cancer, or carcinoma in situ of the cervix No concurrent advanced medical illness or psychologic disease No prohibitive medical risk for chemotherapy Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception PRIOR CONCURRENT THERAPY: Biologic therapy Not specified Chemotherapy See Disease Characteristics No prior systemic chemotherapy for bladder cancer At least 5 years since other prior systemic chemotherapy Prior intravesical therapy allowed Randomization group: Prior intravesical therapy allowed if administered prior to cystectomy Endocrine therapy Not specified Radiotherapy No prior pelvic irradiation Surgery See Disease Characteristics
Sites / Locations
- Banner Thunderbird Medical Center
- Banner Good Samaritan Medical Center
- CCOP - Western Regional, Arizona
- USC/Norris Comprehensive Cancer Center and Hospital
- North Colorado Medical Center
- McKee Medical Center
- Saint Anthony's Hospital at Saint Anthony's Health Center
- Cardinal Bernardin Cancer Center at Loyola University Medical Center
- Good Samaritan Regional Health Center
- St. Francis Hospital and Health Centers - Beech Grove Campus
- Cancer Center of Kansas, P.A. - Chanute
- Cancer Center of Kansas, P.A. - Dodge City
- Cancer Center of Kansas, P.A. - El Dorado
- Veterans Affairs Medical Center - Kansas City
- Cancer Center of Kansas, P.A. - Kingman
- Southwest Medical Center
- Cancer Center of Kansas, P.A. - Newton
- Cancer Center of Kansas, P.A. - Parsons
- Cancer Center of Kansas, P.A. - Pratt
- Cancer Center of Kansas, P.A. - Salina
- Salina Regional Health Center
- Cancer Center of Kansas, P.A. - Wellington
- Associates in Womens Health, P.A. - North Review
- Cancer Center of Kansas, P.A. - Medical Arts Tower
- Cancer Center of Kansas, P.A. - Wichita
- CCOP - Wichita
- Via Christi Cancer Center at Via Christi Regional Medical Center
- Cancer Center of Kansas, P.A. - Winfield
- Veterans Affairs Medical Center - Shreveport
- Feist-Weiller Cancer Center at Louisiana State University Health Sciences
- University of Michigan Comprehensive Cancer Center
- William Beaumont Hospital - Royal Oak Campus
- Southeast Missouri Regional Cancer Center at Southeast Missouri Hospital
- St. Francis Medical Center
- CCOP - St. Louis-Cape Girardeau
- David C. Pratt Cancer Center at St. John's Mercy
- Big Sky Oncology
- Sletten Regional Cancer Institute
- Herbert Irving Comprehensive Cancer Center at Columbia University
- James P. Wilmot Cancer Center at University of Rochester Medical Center
- Cleveland Clinic Taussig Cancer Center
- Grandview Hospital
- Good Samaritan Hospital
- David L. Rike Cancer Center at Miami Valley Hospital
- Samaritan North Cancer Care Center
- Veterans Affairs Medical Center - Dayton
- CCOP - Dayton
- Community Oncology Group at Cleveland Clinic Cancer Center
- Charles F. Kettering Memorial Hospital
- Middletown Regional Hospital
- UVMC Cancer Care Center at Upper Valley Medical Center
- Cleveland Clinic - Wooster
- Ruth G. McMillan Cancer Center at Greene Memorial Hospital
- Brooke Army Medical Center
- Wilford Hall Medical Center
- Veterans Affairs Medical Center - San Antonio (Murphy)
- Cancer Therapy and Research Center
- University Hospital - San Antonio
- University of Texas Health Science Center at San Antonio
- Sentara Cancer Institute at Sentara Norfolk General Hospital
- St. Joseph Hospital Community Cancer Center
- Olympic Hematology and Oncology
- Skagit Valley Hospital Cancer Care Center
- CCOP - Virginia Mason Research Center
- Group Health Central Hospital
- Harborview Medical Center
- Fred Hutchinson Cancer Research Center
- Swedish Cancer Institute at Swedish Medical Center - First Hill Campus
- University Cancer Center at University of Washington Medical Center
- North Puget Oncology at United General Hospital
- Cancer Care Northwest - Spokane South
- Wenatchee Valley Clinic
- Community Comprehensive Cancer Center at Camden-Clark Memorial Hospital
- Toronto Sunnybrook Regional Cancer Centre at Sunnybrook and Women's College Health Sciences Centre
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Experimental
No Intervention
No Intervention
No Intervention
Arm I: M-VAC x 3
Arm II: Observation
Arm III: Observation
Arm IV: Observation
Patients with altered (+) p53, reconsented to randomization, randomized to three cycles of MVAC
Patients with altered (+) p53, reconsented to randomization, randomized to observation
Patients with unaltered (-) p53
Patients with altered (+) p53, patients did not consent to randomization