Combination Chemotherapy in Treating Patients With Advanced Bladder or Kidney Cancer

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