Chemotherapy in Treating Patients With Early-Stage Bladder Cancer

You may be eligible if

• DISEASE CHARACTERISTICS:
• Histologically confirmed recurrent superficial bladder cancer defined as papillary transitional cell carcinoma (stage Ta/T1) and/or carcinoma in situ (stage Tis) of the urinary bladder
• * No evidence of invasion of the underlying muscle (stage T2) at baseline
• Must meet 1 of the following criteria:
• * Failure of at least 2 prior courses of intravesical therapy, 1 of which must have been a course of BCG
• * Recurrent or persistent disease within 6 months after failing a 6-week course of BCG followed by maintenance therapy
• * Inability or ineligibility to complete 1 course of intravesical therapy with BCG, and failure of 2 prior courses of intravesical therapy with an alternative agent
• Diagnosis must have been made no more than 24 months after completion of prior treatment with intravesical immunotherapy or chemotherapy
• If carcinoma in situ is current or previous diagnosis, the biopsies must be obtained from at least 4 sites (bladder mapping)
• If prostatic urothelial biopsy discloses carcinoma in situ, transurethral prostatic resection must be carried out prior to study
• Papillary disease must have undergone complete transurethral resection (TURBT) within 28 days before study
• PATIENT CHARACTERISTICS:
• Age:
• 18 and over
• Performance status:
• ECOG 0-1
• Life expectancy:
• Not specified
• Hematopoietic:
• WBC greater than 4,000/mm\^3
• Platelet count greater than 100,000/mm\^3
• Hepatic:
• Bilirubin less than 2 times upper limit of normal (ULN)
• SGOT and SGPT less than 3 times ULN
• Renal:
• Creatinine no greater than 2.5 mg/dL
• Other:
• Normal upper tract (ureter and renal pelvic) evaluation within 6 months
• No known sensitivity to anthracyclines or to Cremophor EL
• HIV negative
• No known AIDS or HIV-1 associated complex
• No other significant concurrent illness
• No other prior malignancy within the past 3 years except superficial bladder cancer, adequately treated basal cell or squamous cell skin cancer, or carcinoma in situ of the cervix
• Not pregnant or nursing
• Fertile patients must use effective contraception
• PRIOR CONCURRENT THERAPY:
• Biologic therapy:
• See Disease Characteristics
• No concurrent biological response modifier therapy
• Chemotherapy:
• See Disease Characteristics
• Prior oral bropirimine for bladder cancer allowed
• No prior AD 32 for bladder cancer
• No other intravenously administered systemic chemotherapy for bladder cancer
• No concurrent chemotherapy for any other malignancy
• Endocrine therapy:
• No concurrent hormonal therapy
• Radiotherapy:
• No prior radiotherapy
• No concurrent radiotherapy
• Surgery:
• See Disease Characteristics