Last year in the UK over 60,000 cancer patients enrolled on clinical trials aimed at improving cancer treatments and making them available to all.
A trial looking at chemotherapy for advanced cancer of the bladder, kidney, urethra or ureter (the urothelial tract) (EORTC 30986)
This trial compared methotrexate, carboplatin and vinblastine (M-CAVI) chemotherapy with gemcitabine and carboplatin (GemCarbo) chemotherapy, to see which works best for cancers of the urothelial tract.
The urothelial tract includes the
- Centre of the kidney (renal pelvis)
- Ureter - the tube that takes urine from the kidney to the bladder
Urethra- the tube that drains urine from the bladder and out of the body
Doctors usually treat cancer of the urothelial tract with chemotherapy, often including cisplatin. But not everyone with advanced urothelial cancer is well enough for cisplatin. So this trial looked at 2 combinations of chemotherapy that didn’t include it.
The aims of this trial were to find out which combination of chemotherapy
- Is better for advanced urothelial tract cancer
- Causes fewest side effects
Summary of results
The research team found that there was no difference in how well the 2 treatments worked, but that M-CAVI caused a few more side effects.
This trial recruited 238 people who had advanced urothelial cancer and were not well enough to have cisplatin chemotherapy.
- 119 had methotrexate, carboplatin and vinblastine (M-CAVI) chemotherapy
- 119 had gemcitabine and carboplatin (GemCarbo) chemotherapy
The research team looked at how many people’s cancer responded to each combination of chemotherapy. They found that
- About 1 in 5 people (21%) who had M-CAVI responded to treatment
- About 1 in 3 people (36.1%) who had GemCarbo responded to treatment
They also looked at how long people lived after treatment. The most common time was
- 8.1 months for those who had M-CAVI
- 9.3 months for those who had GemCarbo
Although these results look like GemCarbo worked better than M-CAVI, the difference was not significant in statistical terms. This means the difference in how well people did in the 2 groups could be down to chance.
The research team found about 1 in 10 people who had GemCarbo had serious side effects, compared to 2 in 10 people who had M-CAVI. The most common side effects were a drop in blood cells, infection and fever.
They concluded that there was no significant difference in how well the treatments worked, but that M-CAVI caused more side effects.
We have based this summary on information from the team who ran the trial. The information they sent us has been reviewed by independent specialists (
How to join a clinical trial
Please note: In order to join a trial you will need to discuss it with your doctor, unless otherwise specified.
Dr Graham Mead
European Organisation for Research and Treatment of Cancer (EORTC)
National Institute for Health Research Cancer Research Network (NCRN)