Chemotherapy in Treating Patients With Early-Stage Bladder Cancer

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