The purpose of this study is to compare the effects, good and/or bad, of the combination of the chemotherapy drugs gemcitabine and cisplatin (chemotherapy) with the combination of gemcitabine, cisplatin, and the experimental drug bevacizumab on you and your transitional cell cancer to find out which is better. Bevacizumab is an antibody that we think can block a protein called VEGF and inhibit the growth of new blood vessels. Bevacizumab has been approved by the FDA for the treatment of metastatic colorectal, lung, and breast cancer, but for transitional cell carcinoma, it is not FDA-approved and should be considered experimental.
Bevacizumab is the common name for the commercial drug Avastin. The bevacizumab used in this trial, however, is for use in research studies only and may be made at locations different from those where Avastin is made. Although some differences may exist, bevacizumab for research use and the commercial drug, Avastin, are manufactured by a similar process, meet similar standards for final product testing and are expected to be very similar in safety and effectiveness. The combination of gemcitabine and cisplatin is one commonly used treatment that has been shown to make some patients with transitional cell carcinoma live longer. This research is being done to see if adding bevacizumab to gemcitabine and cisplatin will delay the growth of your cancer and allow you to live longer.
This is a randomized trial so patients will receive one of two treatments: Arm A: Gemcitabine, cisplatin, and placebo (sugar water or salt water)OR Arm B: Gemcitabine, cisplatin, and bevacizumab (an experimental drug). Arm A is the current standard treatment for patients with this type of cancer. Your participation in this trial will continue for as long the cancer is responding to or is stabilized by the drugs and you do not have any severe side effects from the drugs.
This study is being done to find out if adding trastuzumab to breast radiation therapy will be more effective than breast radiation therapy alone in preventing the occurrence of breast cancer in the same breast, in the other breast, or in other parts of the body.
Trastuzumab is called a targeted therapy because it targets breast cancers that make too much of a protein called HER2. Too much of the HER2 protein can cause cells to receive extra growth signals. Trastuzumab has been shown to block the HER2 protein and to slow down or stop the growth of HER2+ invasive breast cancers.
Patients will be randomized into one of two treatment groups. One group will receive radiation only, and the other group will receive Trastuzumab plus radiation therapy.
The purpose of this study is to find out what effects (good and/or bad) chemotherapy combined with external radiation therapy and possible removal of your bladder has on you and your cancer. The chemotherapy drugs used in this study (5-Fluorouracil, cisplatin, and gemcitabine) are not experimental drugs. This research is being done because we do not know whether one combination of drugs with radiation is superior to another in the treatment of your disease. This study uses similar therapies to the standard treatment, but chemotherapy and radiation therapy are given before removal of the bladder is considered. In this study, bladder removal is advised if, after chemotherapy and radiation, your tumor has not completely disappeared, if your tumor comes back, or if it gets larger.
Patients who participate in this trial will be randomized into two groups. Patients will receive either cisplatin and 5-FU chemotherapy and radiation twice per day OR gemcitabine chemotherapy and radiation once per day. Participation in this study may last up to 8 months with continued follow up after treatment is complete.
The purpose of this study is to compare the effects, good and/or bad, of three different ways to give radiation therapy. Two of the ways are experimental, while one of them is standard.
Patients who participate in this study will be randomized into one of three study groups. Those in the first group will receive radiotherapy everyday for 3 weeks plus 4 cycles of chemotherapy. Those in the second group will receive radiotherapy everyday for 7 weeks plus 4 cycles of chemotherapy. Those in the third group will receive radiotherapy everyday for 5 weeks plus 4 cycles of chemotherapy.
The purpose of this study is to determine if adding bevacizumab to the current standard chemotherapy, namely doxorubicin, cyclophosphamide, and paclitaxel, reduces the risk of recurrence compared to standard chemotherapy alone.
Patients are stratified according to planned dose schedule of doxorubicin and cyclophosphamide. Patients are further stratified according to estrogen receptor status, lymph node involvement, and received/planned radiation and surgery treatment. Patients are randomized to 1 of 3 treatment arms in which they will receive either paclitaxel, placebo, bevacizumab, or a combination of two of these drugs.
In all arms, treatment continues in the absence of disease progression or unacceptable toxicity.