Vinblastine sulfate, 0.10-0.15 mg/kg IV every week, was given to 37 patients with bidimensionally measurable, metastatic transitional cell carcinoma of the urothelial tract. Twenty-eight patients, the majority of whom had received extensive prior chemotherapy, had an adequate trial and five (18%; 95% confidence limits, 3-3370) achieved a partial remission (>so% decrease in tumor size) of 2-5 months' duration. Responding sites included lung and nodal metastases. Toxicity, primarily leukopenia, was mild to moderate. The 18% response rate obtained in heavily pretreated cases suggests that vinblastine sulfate has some efficacy in the treatment of patients with advanced urothelial tract tumors.
Cancer 50:435-438, 1982.
H K E E DRUGS, i.e., cisplatin, methotrexate, and T doxorubicin, have demonstrated some clinical efficacy against disseminated bladder cancer. ' 9 ' However, complete and long-lasting remissions are uncommon and other active agents still need to be defined.' Vinblastine sulfate (VLB), a mitotic spindle inhibitor introduced in 1960, has never been evaluated in patients with transitional cell carcinoma of the urothelial tract: renal pelvis, ureter, urinary bladder, and urethra. In a comprehensive review of all VLB studies which included all Phase 1-11 drug-oriented and Phase 11-111 diseaseoriented trials, only 16 cases could be found, of whom five were given VLB in combination regimen^.^ Since 1978, VLB has been used in a prospective secondary protocol (criteria for patient entry into a primary protocol is lacking because of prior chemotherapy, or renal, auditory biliary or cardiac dysfunction, etc.) at Memorial Sloan-Kettering Cancer Center.'
Materials and Methods
All patients had a complete history and physical examination, an automated blood cell and platelet count,