A Phase II clinical trial of a new anthracycline, 
(2''R)-4'-0-tetrahydropyranyladriamycin (THP), was performed in 137 patients 
with urological malignancies. Out of them, 111 patients were evaluated for tumor 
responses and 125 patients were evaluated for adverse effects. In cases of 
intravenous administration, overall response rate was 18.5% (22.2% for bladder 
cancer, 30.0% for tumors of the renal pelvis and ureter, and 6.7% for prostatic 
cancer). In the case of intra-arterial administration, overall response rate was 
42.9% (50.0% for bladder cancer). For 50 patients with superficial bladder 
cancer intravesical chemotherapy with THP was performed. Sixteen patients showed 
complete disappearance of the tumor, 2 patients showed more than 90% tumor 
regression and 12 patients showed more than 50% tumor regression, respectively. 
Overall response rate was 60%. Cardiotoxicity was minimal. Alopecia was noted in 
a total of 16 patients, but this was minimal. Leukocytopenia was the major 
adverse effect among patients undergoing systemic THP administration. In 
conclusion, THP was most effective against transitional cell carcinoma of the 
urinary tract.