Forty-one evaluable patients with bidimensionally measurable metastases of transitional cell carcinoma of the bladder were treated with cisplatin 70 mg/m2 i.v. on day 1 and VM-26 100 mg/m2 i.v. on days 1 and 2, every 3 weeks. Response was evaluated after 2 treatment cycles. Complete response (CR) was achieved in 4 patients (10%) and partial response (PR) in 17 (41%). The median response duration was 6 months. In this group of previously untreated patients the combination of cisplatin and VM-26 did not appear to yield better response rates than would be expected from cisplatin alone.