Combination Chemotherapy in Treating Patients With Advanced Bladder or Kidney Cancer

You may be eligible if

• DISEASE CHARACTERISTICS:
• Histologically confirmed advanced transitional cell urothelial cancer
• * Clinical Stage IV: T any, N1-3, M0; T any, N any, M1; or cT4, Nx, M0 (bladder tumors)
• * Pathological Stage III or IV bladder cancer: T any, N1-3, M0; T3b, N0, M0; T4, N0, M0; and T4, Nx, M0
• * Pathological Stage III or IV urothelial cancer of the renal pelvis or ureter: T any, N1-3, M0; T3, N0, M0; T4, N0, M0; and surgery has been performed within 10 weeks of initiation of therapy
• Impaired renal function (See Renal function tests)
• PATIENT CHARACTERISTICS:
• Age:
• 18 and over
• Performance status:
• Karnofsky 60-100% OR
• ECOG 0-1
• Life expectancy:
• Not specified
• Hematopoietic:
• Granulocyte count at least 1,500/mm\^3
• Platelet count at least 150,000/mm\^3
• Hepatic:
• Bilirubin less than 1.5 times normal
• Alkaline phosphatase less than 2 times normal
• SGOT less than 2 times normal
• Renal:
• Creatinine greater than 1.5 mg/dL but no greater than 2.5 mg/dL OR
• Creatinine clearance 30-59 mL/min
• Cardiovascular:
• Normal cardiac function by history, physical examination, and chest radiograph OR
• If prior cardiac disease, left ventricular ejection fraction must be at least 50% by radionuclide ventriculogram or echocardiogram
• No serious cardiac arrhythmias; including first, second, and third degree heart block
• No New York Heart Association class III or IV heart disease
• Other:
• No uncontrolled infection
• No other active cancer, except nonmelanomatous skin cancer and in situ carcinoma of the cervix curatively treated
• Not pregnant
• Effective barrier contraception required for all fertile patients during and for 6 months after therapy (encouraged to continue for 2 years or longer)
• PRIOR CONCURRENT THERAPY:
• Biologic therapy:
• Not specified
• Chemotherapy:
• No prior systemic chemotherapy
• Endocrine therapy:
• Not specified
• Radiotherapy:
• No prior radiotherapy to the bladder
• At least 4 weeks since any other prior radiotherapy
• Surgery:
• See Disease Characteristics