This information is about a chemotherapy treatment called MVP. Usually it is used to treat lung cancer or mesothelioma (cancer of the lining of the lungs). This information describes the drugs used, how they are given and some of the possible side effects. If you have any questions you can ask your doctor or nurse at the hospital where you are having your treatment, or speak to one of our cancer support service nurses.

MVP is named after the chemotherapy drugs used in the treatment, which are:

• mitomycin
• vinblastine
• cisplatin.

MVP treatment can usually be given to you as a day patient. You will need a blood test before you start treatment – either on the same day, or a few days beforehand. You will also be seen by a doctor, specialist nurse or pharmacist. If the results of your blood test are normal the pharmacy will prepare your chemotherapy drugs. This may take several hours.

The nurse will then put a fine tube (cannula) into a vein in your hand or arm. You may find this uncomfortable or a little painful, but it should not last long. Some people have their chemotherapy given through a fine plastic tube that is inserted under the skin into a vein near the collarbone (a central line), or passed through a vein in their arm (a PICC line). Your doctor or nurse will explain more about this to you.

Once your chemotherapy is ready you will be given some anti-sickness (anti-emetic) drugs. These are usually given by injection through the cannula, which is connected to a drip, although some anti-sickness medicines may also be given as tablets.

The chemotherapy drugs are then given separately:

• mitomycin (a purple fluid) is given as an injection along with a drip of salt water (saline) into your cannula
• vinblastine (a colourless fluid) is given in the same way
• cisplatin (a colourless fluid) is given as a drip (infusion).

Altogether, your treatment will usually take approximately 8–12 hours, although it can be quicker than this. The mitomycin is often given first, although the drugs can be given in a different order without altering their effectiveness.

Before and after the treatment with cisplatin you will be given plenty of fluid through your drip to keep your kidneys working normally.

If you are having your treatment as a day patient you can then go home. The cannula will be removed and you will be given a supply of anti-sickness drugs to take with you. It is important to take these as directed even if you are not feeling sick, as some anti-sickness drugs are much better at preventing sickness than stopping it once it has started.

You may hear your doctor use the words 'regimen' or 'regime' (eg MVP regime) when talking about your chemotherapy. This just means the whole plan or schedule of the chemotherapy treatment that you are receiving.

On the first day of your treatment you will be given all three drugs (mitomycin, vinblastine and cisplatin) as described above. You will then have a rest period with no chemotherapy for three weeks. This completes one cycle of the chemotherapy. After the three-week rest period, the next chemotherapy cycle will start.

In some hospitals the mitomycin may not be given during some cycles because it can cause you to have very low numbers of blood cells (see Possible side effects, below).

Each person's reaction to chemotherapy is different. Some people have very few side effects, while others may experience more. The side effects described here will not affect everyone who is having MVP chemotherapy. We have outlined the most common side effects, but we have not included those that are rare and therefore unlikely to affect you. If you notice any effects that you think may be due to the drug, but that are not listed here, please let your nurse or doctor know.

Lowered resistance to infection The chemotherapy can reduce the production of white blood cells by the bone marrow, making you more prone to infection. This effect can begin seven days after treatment has been given, with your resistance to infection usually reaching its lowest point 10–14 days after chemotherapy. Your blood cells will then increase steadily and will usually have returned to normal levels before your next cycle of chemotherapy is due.

Contact your doctor or the hospital straightaway if:

• your temperature goes above 38ºC (100.5ºF)
• you suddenly feel unwell (even with a normal temperature).

You will have a blood test before having more chemotherapy to make sure that your number of white blood cells has returned to normal. Occasionally, it may be necessary to delay treatment if your number of blood cells (blood count) is still low.

Bruising or bleeding The chemotherapy can reduce the production of platelets (which help the blood to clot). Let your doctor know if you have any unexplained bruising or bleeding, such as nosebleeds, blood spots or rashes on the skin, or bleeding gums.

Anaemia (low number of red blood cells) While having treatment with MVP you may become anaemic. This may make you feel tired and breathless. Let your doctor or nurse know if these effects are a problem.

Feeling sick (nausea) and being sick (vomiting) Your doctor can prescribe very effective anti-sickness (anti-emetic) drugs to prevent or reduce nausea and vomiting. If the sickness is not controlled, or if it continues, tell your doctor. They can prescribe other ant‑sickness drugs that may be more effective. Some anti-sickness drugs may cause constipation. Let your doctor or nurse know if this is a problem.

Tiredness Many people feel extremely tired (fatigued) during chemotherapy, particularly towards the end of treatment. This is a very common side effect and it is important to try to get as much rest as you need.

Hair loss This tends to start 2–3 weeks after the first cycle of treatment. Hair usually thins rather than falling out completely. The hair loss is temporary and your hair will start to grow again once treatment has finished.

Sore mouth and ulcers Your mouth may become sore or dry, or you may notice small ulcers during this treatment. Tell your nurse or doctor if you do have any of these problems, as they can give you special mouthwashes and medicine to prevent or clear any mouth infection.

Taste changes You may notice that your food tastes different. Normal taste will usually come back after the treatment finishes.

Numbness or tingling in hands or feet This is due to the effect of vinblastine and cisplatin on nerves and is known as peripheral neuropathy. Tell your doctor if you notice these symptoms. The problem usually improves slowly a few months after treatment is over.

Aching joints and muscles You may have these symptoms a few days after treatment. This does not usually last long and your doctor can prescribe painkillers to help.

Ringing in your ears and hearing loss Cisplatin can cause some ringing in the ears (tinnitus). It can also cause some loss of ability to hear high-pitched sounds. This usually improves when the treatment is over. Tell your doctor if you notice any loss of hearing or ringing in your ears.

Your kidney function may be affected Usually this does not cause any symptoms and the effect on the kidneys is mild. Rarely it may cause permanent damage to the kidneys unless treatment is stopped. Before each treatment you will have a blood test to check your kidney function.

You may be asked to drink more than normal during the day after your treatment. It is important to tell your doctor or chemotherapy nurse if you are not able to drink enough. Also, let your doctor or nurse know if you are not passing as much urine as normal.

Changes to the lungs Mitomycin may cause some mild inflammation of the lung tissue. Let your doctor know if you notice any coughing or breathlessness.

Always let your doctor or nurse know about any side effects you are having. There are usually ways in which they can be controlled or improved.

Risk of blood clots Cancer can increase your risk of developing a blood clot (thrombosis), and having chemotherapy may increase this risk further. A blood clot may cause symptoms such as pain, redness and swelling in a leg, or breathlessness and chest pain. Blood clots can be very serious, so it is important to tell your doctor straightaway if you have any of these symptoms. However, most clots can usually be successfully treated by using drugs which thin the blood. Your doctor or nurse can give you more information. 

Other medicines Some medicines can be harmful to take when you are having chemotherapy. Always tell your doctor about any medicine you are taking. This includes any medicines that you may have bought from a pharmacy or supermarket and any herbal or complementary therapies.

Leakage into the tissue around the vein If mitomycin or vinblastine leak into the tissue around the vein, the cells in that area can be damaged. If you notice any stinging or burning around the vein while either drug is being given, tell the doctor or nurse immediately.

Fertility Your ability to become pregnant or father a child may be affected by this treatment. It is important to discuss fertility with your doctor before starting treatment.

Contraception It is not advisable to become pregnant or father a child while taking this treatment, as the developing foetus may be harmed. It is important to use effective contraception while taking this drug, and for at least a few months afterwards. Again, discuss this with your doctor.

This section is based upon our MVP chemotherapy factsheet which has been compiled using information from a number of reliable sources, including:

• Martindale: The Complete Drug Reference (35th edition). Eds. Sweetman et al. Pharmaceutical Press, 2007.
• British National Formulary (54th edition). British Medical Association and Royal Pharmaceutical Society of Great Britain, September 2007.
• The Chemotherapy Source Book (3rd edition). Ed. Perry. Lippincott, Williams and Wilkins, 2001.

For further references, please see general bibliography.