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.