Combination Chemotherapy in Treating Patients With Metastatic or Locally Advanced Bladder Cancer

DISEASE CHARACTERISTICS:

• Histologically confirmed transitional cell carcinoma of the urothelium
• Measurable disease, defined as unresectable or metastatic urothelial tract tumors OR
• Evaluable disease, defined as T3b or T4a bladder tumors

PATIENT CHARACTERISTICS:

Age:

• 18 and over

Performance status:

• Karnofsky 70-100%

Life expectancy:

• Not specified

Hematopoietic:

• Granulocyte count greater than 1,500/mm^3
• Platelet count greater than 150,000/mm^3

Hepatic:

• Bilirubin less than 1.5 times normal
• SGOT less than 2 times normal

Renal:

• Creatinine less than 1.5 mg/dL OR
• Creatinine clearance greater than 60 mL/min

Cardiovascular:

• No New York Heart Association class III or IV heart disease
• No serious cardiac arrhythmias, including first, second, or third degree heart block
• LVEF at least 50%

Other:

• No uncontrolled infection
• No other active malignancy except curatively treated nonmelanomatous skin cancer or carcinoma in situ of the cervix
• Fertile patients must use effective barrier contraception before, during, and for 6 months after study and are encouraged to continue for 2 years or longer after study

PRIOR CONCURRENT THERAPY:

Biologic therapy:

• Not specified

Chemotherapy:

• No prior systemic chemotherapy

Endocrine therapy:

• Not specified

Radiotherapy:

• At least 3 weeks since prior radiotherapy

Surgery:

• See Disease Characteristics