Cyclophosphamide, doxorubicin, and cisplatin (CAP) in the treatment of urothelial malignancy: a pilot study of the Southeastern Cancer Study Group.

Thirty-four patients with urothelial malignancy were treated with a chemotherapy regimen of cyclophosphamide, doxorubicin, and cisplatin. The objective response rate was 38% (13 of 34 patients), with three patients achieving a complete remission. Objective responders had a significantly longer median survival time than nonresponders (225 vs 137 days [P less than or equal to 0.04]). The median duration of remission was 177 days. Hematologic toxic effects were initially severe, with three episodes of sepsis and one death, but were acceptable after dose modification. This study demonstrates that the regimen of cyclophosphamide, doxorubicin, and cisplatin is effective in metastatic urothelial malignancy. Although response duration was short (25 weeks), responders clearly lived longer than nonresponders.