• Detection of genes associated with sensitivity to the chemotherapy in tumor size reduction of original bladder tumor [ Designated as safety issue: No ]
  

• Safety [ Designated as safety issue: Yes ]
  
• Overall survival rate [ Designated as safety issue: No ]
  
• Size reduction of metastatic lesion [ Designated as safety issue: No ]
  

OBJECTIVES:

Primary

• Analyze the correlation between gene expression profile and the effect of chemotherapy and detect the significant cluster of genes useful to predict chemosensitivity.
• Confirm the reduction in original tumor size in patients with invasive bladder cancer treated with methotrexate, vinblastine, doxorubicin hydrochloride, and cisplatin.

Secondary

• Determine the safety of this regimen in these patients.
• Determine the overall survival rate in patients treated with this regimen.
• Assess the reduction in size of metastatic lesions in patients treated with this regimen.

OUTLINE: This is a multicenter study.

Patients receive methotrexate on days 1, 15, and 22, vinblastine on days 2, 15, and 22, doxorubicin hydrochloride and cisplatin on day 2. Treatment repeats every 4 weeks in the absence of disease progression or unacceptable toxicity.

Patient samples will be collected for gene expression profiling.

After completion of study treatment, patients are followed for 3 years.

DISEASE CHARACTERISTICS:

• Diagnosis of invasive bladder cancer
• Must be confirmed by chest and abdominal CT scan OR pelvic MRI scan and transurethral biopsy (with definitive muscle invasion > T2) within 4 weeks prior to registration

PATIENT CHARACTERISTICS:

• ECOG performance status 0-1
• WBC ≥ 3,000/mm^3
• Neutrophil count ≥ 1,500/mm^3
• Platelet count ≥ 100,000/mm^3
• Total bilirubin ≤ 1.5 mg/dL
• Serum creatinine ≤ 1.5 mg/dL
• AST and ALT ≤ 2.5 x upper limit of normal
• Not pregnant
• No liver cirrhosis
• No ischemic cardiovascular disease or arrhythmia for which treatment is necessary
• No cardiac infarction within the past 6 months
• No interstitial pneumonia, pulmonary fibrosis, or any other diseases by which oxygen inhalation therapy is needed
• No active cancerous lesion other than upper urinary tract tumor
• No high fever or any other infectious symptom
• No uncontrolled hypertension or diabetes mellitus

PRIOR CONCURRENT THERAPY:

• No prior systemic chemotherapy