durvalumab + methotrexate + vinblastine + doxorubicin + cisplatin

This is a **combination regimen** of five drugs: four chemotherapeutic agents—methotrexate, vinblastine, doxorubicin, and cisplatin (collectively known as MVAC)—plus durvalumab, a monoclonal antibody checkpoint inhibitor targeting PD-L1. The MVAC regimen is well-established in oncology for its synergistic antineoplastic effects: - **Methotrexate** is an antimetabolite that inhibits dihydrofolate reductase, blocking DNA synthesis. - **Vinblastine** disrupts microtubule formation by binding to tubulin, inhibiting mitosis. - **Doxorubicin** intercalates into DNA and inhibits topoisomerase II, causing DNA damage. - **Cisplatin** induces DNA crosslinking and apoptosis. **Durvalumab** augments the regimen by blocking PD-L1, enabling T-cell mediated immune responses against tumor cells. This combination is in clinical trials for high-grade urothelial carcinoma, especially upper tract urothelial carcinoma. Studies are focused on neoadjuvant settings to improve event-free survival, pathologic complete response, and overall survival, compared to chemotherapy alone[2][4][6][7].

Brand names

MVAC

Other names

aMVAC + durvalumabMVAC + durvalumab