Efficacy of Combination of Trastuzumab to Gemcitabine - Platinum Advanced or Metastatic Urothelial Carcinoma

Inclusion Criteria: * Transitional cell carcinoma of the urothelium or bladder histologically proven stage IV AJCC \[locally advanced (T4b and / or N + M0) unresectable or metastatic (M1)\] * Tumor and / or metastasis overexpressing HER2 immunohistochemistry (IHC 3 +) or IHC 2 + and FISH +. Centralized analysis. * Measurable disease with at least one lesion with a diameter\> 2 cm for conventional methods (clinical examination, CT or MRI) or\> 1 cm for the helical scanner. In case of single metastasis, metastatic disease should be histologically proven * Age ≥ 18 years and ≤80 years * Life expectancy\> 3 months, * Index performance status \<2 according to ECOG PS, * No prior chemotherapy other than adjuvant and / or neoadjuvant chemotherapy, without Herceptin ® and complete for more than 6 months (naive to any previous chemotherapy in the metastatic setting) * No radiotherapy within 4 weeks prior to inclusion, * Normal cardiac function as measured by ejection fraction (LVEF\> 50%), * Blood and liver satisfactory constants: Hematological criteria: - Neutrophils\> 1.5 x 109 / L, - Chips\> 100 x 109 / L - Hemoglobin\> 10 g / dL, Liver function: - Alkaline phosphatase (unless bone metastases) \<2 x N - Total bilirubin \<1.5 x N - transaminases (AST, ALT) \<1.5 x N, renal Constants: - Creatinine clearance \> 30 ml / min (Cockcroft and Gault, cf. Annex XV protocol) \- Patient's written consent after full information. Exclusion Criteria: * Concurrent treatment with an experimental drug, participation in another clinical trial within \<30 days * Patients previously treated with Herceptin ®, or another treatment targeting growth factors EGF (eg Iressa ®, Tarceva ®) * Existence of a severe pulmonary disease, liver or kidney is likely to be exacerbated by the treatment, * Other medical conditions: congestive heart failure or angina pectoris even if medically controlled failure, history of myocardial infarction before entering the trial, hypertension or uncontrolled arrhythmias, significant valvular disease, * Patient with dyspnoea at rest or requiring oxygen therapy or with respiratory failure, * Presence of a severe infection requiring antibiotics, * Presence of CNS metastases or meningeal * History of another malignancy uncured or cured for less than 5 years (except basal cell carcinoma, papillary thyroid carcinoma in situ of the cervix treated) * Pregnant or lactating or not using effective contraception Women, * For Cisplatin only: carrying a serious neurological disease, current events devices\> NCI grade 2 neuropathy, hearing loss, creatinine clearance \<60 ml / min, the patient can not support a patient hydration.