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MVAC: Chemotherapy for Bladder Cancer
MVAC is an acronym and stands for a combination chemotherapy treatment for advanced bladder cancer: methotrexate (M), vinblastine (V), Adriamycin (A) (= doxorubicin) and cisplatin (C).
Indications for MVAC Chemotherapy
- Metastatic bladder cancer or metastatic transitional cell carcinoma of ureter or renal pelvis
- Adjuvant chemotherapy (after cystectomy) or neoadjuvant chemotherapy (before and after cystectomy) for advanced bladder cancer (T3–4 N1–3).
Since the combination chemotherapy treatment with Cisplatin-Gemcitabine is less toxic, MVAC is the second choice chemotherapy for bladder cancer (Von der Maase et al., 2000).
Dosage of MVAC Chemotherapy
One cycle of MVAC lasts 28 days. If well tolerated, metastases are treated with 6 cycles. Adjuvant or neoadjuvant treatment with MVAC is usually done with 4 cycles. Treatment of MVAC should be stopped due to progressive toxicity or due to progressive disease under treatment.
- Methotrexate: 30 mg/m2, days 1, 15, 22
- Vinblastine: 3 mg/m2, days 2, 15, 22
- Adriamycin (= Doxorubicin): 30 mg/m2, day 2
- Cisplatin: 70 mg/m2, day 2
- Folinic acid: 12 mg 1–0–1 p.o. days 2, 16, 23
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References
Von der Maase, H.; Hansen, S. W.; Roberts, J. T.; Dogliotti, L.; Oliver, T.; Moore, M. J.; Bodrogi, I.; Albers, P.; Knuth, A.; Lippert, C. M.; Kerbrat, P.; Sanchez Rovira, P.; Wersall, P.; Cleall, S. P.; Roychowdhury, D. F.; Tomlin, I.; Visseren-Grul, C. M. & Conte, P. F. Gemcitabine and cisplatin versus methotrexate, vinblastine, doxorubicin, and cisplatin in advanced or metastatic bladder cancer: results of a large, randomized, multinational, multicenter, phase III studyJ Clin Oncol, 2000, 18, 3068-77
Deutsche Version: MVAC Chemotherapie des fortgeschrittenen Harnblasenkarzinoms