Dose-dense MVAC
Checked 2026-09-09
Muscle-invasive bladder cancer, cisplatin-eligible, before cystectomy
Also called ddMVAC, accelerated MVAC.
One cycle
every 14 days × 3-4 · about 6 weeks in totalComponents
| Drug | Dose | Route | Days | Note |
|---|---|---|---|---|
Methotrexate Antifolate (DHFR inhibitor) | 30 mg/m² | IV | D1 | |
Vinblastine Vinca alkaloid (microtubule inhibitor) | 3 mg/m² | IV | D2 | |
Doxorubicin Cytotoxic chemotherapy (anthracycline) | 30 mg/m² | IV | D2 | |
Cisplatin Cytotoxic chemotherapy (platinum) | 70 mg/m² | IV | D2 |
Cycles
3-4 (6 in VESPER)
14-day cycle
Emetogenicity
High (>90%)
G-CSF
Built into the protocol
Notes
- NIAGARA (gemcitabine-cisplatin + durvalumab) is the alternative perioperative standard.
Used in
Trials
Source
NCCN Bladder Cancer; Sternberg (EORTC 30924), JCO 2001
Reference doses for a typical adult from the cited protocol or label. Doses are adjusted for renal and hepatic function, age, performance status and prior toxicity, and institutional protocols vary. Verify against the current label and your local protocol before treating. Not medical advice.
Other regimens for these cancers
Gemcitabine + cisplatin
Advanced biliary tract cancer first line (with durvalumab or pembrolizumab); cisplatin-eligible urothelial cancer
every 21 days × 8
Sacituzumab govitecan
Metastatic TNBC after two lines (one for metastatic disease); HR-positive after endocrine therapy and two chemotherapies
every 21 days
Enfortumab vedotin + pembrolizumab
Locally advanced or metastatic urothelial cancer, first line, regardless of cisplatin eligibility
every 21 days
Intravesical BCG, induction and maintenance
High-risk non-muscle-invasive bladder cancer after complete TURBT
weekly × 6