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

Cancer type:

Bladder cancer

Kidney cancer

Transitional cell cancer

Status:

Results

Phase:

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 - 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.