Mellema, Jan-Jaap J. and van Rhijn, Bas W. G. and van der Heijden, Michiel S. (2023) Recent developments in perioperative combination therapy in muscle-invasive bladder cancer. CURRENT OPINION IN UROLOGY, 33 (5). pp. 404-411. ISSN 0963-0643, 1473-6586
Full text not available from this repository. (Request a copy)Abstract
Purpose of review A summary of recent literature to provide a comprehensive overview of the current state of systemic perioperative treatment combinations for muscle-invasive bladder cancer (MIBC). Recent findings We discuss recent developments in standard and experimental treatment modalities. The VESPER trial has shown that six cycles of neoadjuvant dose-dense MVAC are superior to four cycles of gemcitabine/cisplatin (GC), though it is unclear whether the superiority is derived from the specific regimen or number of cycles. Adjuvant cisplatin-based chemotherapy, a subject of longstanding debate, was shown to have comparable overall survival-benefit to neoadjuvant chemotherapy in an updated meta-analysis. Neoadjuvant chemotherapy and anti-PD-(L)1 show encouraging results, but with no comparative studies to standard care, context is lacking. Immunotherapeutic neoadjuvant anti-CTLA-4/PD-(L)1 combinations or combinations of checkpoint inhibitors with antibody-drug-conjugates are in early stages of development and show promising preliminary results. Summary Six cycles of neoadjuvant dose-dense MVAC are superior to four cycles of gemcitabine/cisplatin. Adjuvant cisplatin-based chemotherapy is a viable option for patients with high-risk tumours who did not receive prior neoadjuvant treatment. The added value of anti-PD-(L)1 to chemotherapy still needs to be established. Novel developments in immunotherapy combinations, while promising, are still in an early stage and randomized studies are ongoing.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | UROTHELIAL CARCINOMA; NEOADJUVANT CHEMOTHERAPY; OPEN-LABEL; PHASE-II; PEMBROLIZUMAB; NIVOLUMAB; ADJUVANT; ATEZOLIZUMAB; MULTICENTER; CYSTECTOMY; chemotherapy; combination therapy; immunotherapy; muscle-invasive bladder cancer; perioperative treatment; urothelial carcinoma |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Urologie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 14 May 2024 07:46 |
| Last Modified: | 14 May 2024 07:46 |
| URI: | https://pred.uni-regensburg.de/id/eprint/60043 |
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