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Phase II, single arm, open investigation of the safety, efficacy and pharmacokinetics of the agent, AZD4877. Concentration: 5 mg/ml concentrate: 25 mg dose, 1 hour IV infusion once per week for 3 weeks. Dose preparation: 5.0 ml of 5 mg/ml added to 250 ml NaCl 0.9%. Pre Treatment: Anti-emetics, growth factors are allowed. Cycle: 4 week regimen. IV infusion each week for 3 weeks as long as tolerated per treating MD. Expected complications: - Fatigue - Nausea - Neutropenia - Thrombocytopenia - Anemia Less Common complications seen in individual patients: Chills, Pain – abdominal, pulmonary emboli, Pneumonia, Bleeding, Rash, Arial Fibrillation. Clinical tests: Pre dose hematology for all treatments Pre dose chemistry (+mg, +PO) & UA at C1, C2 and Q 3 months COAG (PT, PTT a nd INR)at screening. 12 L ECG at screening X 3 and C1D1 at end of dose. RECIST CT at screen, pre C3, then Q 8 weeks Research Labs: Pharmacokinetics Cycle 1 Day 1: Pre dose, 55 min after start and 5 min and 1 hour after end of infusion in clinic. Cycle 1 Day 8: Pre dose, 55 min after start. Assess patients' safety and tolerabililty. Collect information on lab tests and any complications.

Patients diagnosed with advanced urothelial, transitional cell carcinoma of the following:
- Bladder, renal pelvis, ureter, urethra.
- Stage IV cancer, not amenable to surgery or radiotherapy.
- Good kidney function: Serum creatinine should be adequate.
- Adequate hematology and chemistry including liver Fx.
- Measurable target lesions by CT.

Provide written consent to participate in the study. Come into the VMMC clinic once a week for a one hour infusion through your port or IV. Allow research samples to be drawn at Cycle 1 and Cycle 2 (day 1 only). Allow quality of life assessments (answer questionnaires). Have a CT every 8 weeks. Allow follow-up telephone calls from research staff.

Study Summary:

Detailed Study Description:

Study Design: Interventional
Phase of Study: Phase II
Study Type: Interventional
Condition or Study Focus: Urothelial, predominantly Transitional Cell Carcinoma; advanced and recurrent. Not amenable to radiation therapy or surgery.
Intervention Type: Intravenous infusion for one hour, every 3 weeks; 4th week off. PK draws on Days 1 of Cycles 1 and 2.
Intervention Name: AZD4877
Gender: Male and Female
Age group: Interventional
Sponsor: AstraZeneca