A trial looking at chemotherapy for advanced cancer of the bladder, kidney, urethra or ureter (the urothelial tract) (EORTC 30986)

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Cancer type:

Bladder cancer
Kidney cancer
Transitional cell cancer




Phase 3

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
  • Bladder
  • Urethra Open a glossary item - 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 (peer reviewed Open a glossary item) and published in a medical journal. The figures we quote above were provided by the trial team. We have not analysed the data ourselves.

Recruitment start:

Recruitment end:

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.

Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Chief Investigator

Dr Graham Mead

Supported by

European Organisation for Research and Treatment of Cancer (EORTC)
National Institute for Health Research Cancer Research Network (NCRN)

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Last review date

CRUK internal database number:

Oracle 287

Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Wendy took part in a new trial studying the possible side effect of hearing loss

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"I was delighted to take part in a clinical trial as it has the potential to really help others in the future.”

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