Pemetrexed Disodium and Gemcitabine in Treating Patients With Advanced Cancer of the Urothelium

You may be eligible if

• DISEASE CHARACTERISTICS:
• Histologically confirmed cancer of the urothelium (renal pelvis, ureter, bladder, or urethra)
• * Any of the following types:
• * Transitional cell carcinoma (TCC)
• * Mixed histologies containing a component of TCC
• * Non-TCC of the urothelium (renal pelvis, ureter, bladder, or urethra)
• Progressing regional or metastatic disease
• Measurable disease
• No clinical evidence of CNS metastases
• No evidence of clinically significant (by physical exam or plain film) third-space fluid collections (pleural effusions or ascites)
• PATIENT CHARACTERISTICS:
• Age
• 18 and over
• Performance status
• ECOG 0-2
• Life expectancy
• Not specified
• Hematopoietic
• Granulocyte count at least 1,500/mm\^3
• Platelet count at least 100,000/mm\^3
• Hemoglobin at least 9 g/dL
• Hepatic
• AST no greater than 3 times upper limit of normal (ULN)
• Bilirubin no greater than 1.5 times ULN
• Renal
• Creatinine clearance at least 45 mL/min
• Cardiovascular
• No history of severe cardiovascular disease (i.e., American Heart Association class III or IV heart disease)
• No uncontrolled congestive heart failure
• No ventricular dysrhythmias
• Other
• Not pregnant or nursing
• Fertile patients must use effective contraception
• No active unresolved infection
• No other prior malignancy unless curatively treated and disease free for an appropriate (disease-specific) period of time
• Able and willing to receive folic acid and cyanocobalamin supplementation
• PRIOR CONCURRENT THERAPY:
• Biologic therapy
• No prior systemic biologic response modifier therapy
• Chemotherapy
• No prior systemic chemotherapy for metastatic disease
• More than 1 year since prior neoadjuvant or adjuvant chemotherapy
• Endocrine therapy
• Not specified
• Radiotherapy
• At least 4 weeks since prior radiotherapy and recovered
• No prior pelvic radiotherapy
• No concurrent radiotherapy
• Surgery
• At least 4 weeks since prior major surgery and recovered
• Other
• More than 7 days since prior parenteral antibiotics
• No salicylates for 2 days before, during, and for 2 days after administration of pemetrexed disodium
• No nonsteroidal anti-inflammatory drugs for at least 5 days before, during, and for 2 days after administration of pemetrexed disodium