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Chemotherapy for metastatic transitional carcinoma of the urinary tract: A prospective trial of methotrexate, adriamycin, and cyclophosphamide (MAC) with cis‐platinum for failure

Fifty‐two patients with metastatic transitional cell carcinoma (TCC) of the urinary tract were treated with methotrexate, Adriamycin and cyclophosphamide (MAC). Objective responses lasting at least three months were seen in 15 (two CR, 13 PR) of 38 patients with measurable disease (response rate = 39%, with 95% confidence limits 24–57%). Median duration of response was six months (range, 3–12 months). In addition, there was clinical or other evidence of response for ⩾ 3 months in four of 14 patients with evaluable but nonmeasurable lesions. Sixteen patients who failed or relapsed after MAC chemotherapy received cis‐platinum and none responded. MAC chemotherapy can provide significant palliation to some patients with TCC and is usually better tolerated than cis‐platinum.