Neoadjuvant therapy in urothelial cancer

SummaryNeoadjuvant cisplatin-based chemotherapy is standard treatment for muscle-invasive bladder cancer before radical cystectomy (RC). Despite level  1 evidence demonstrating an overall survival benefit for patients undergoing RC after neoadjuvant chemotherapy (NAC), acceptance rates are still low. In high-risk upper tract urothelial cancer (UTUC), cumulative evidence suggests that NAC for locally advanced UTUC can improve oncological outcome. Ongoing phase 3 trials will finally prove the benefit or futility of NAC in this tumor entity. Since urothelial cancer (UC) is a heterogeneous disease, predictive biomarkers are needed to select specific patient populations and potentially increase response rates to NAC. Novel targeting therapie s, including immune checkpoint inhibitors, have been approved for metastatic UC. In combination with predictive biomarkers, these might have the potential to change systemic therapy for UC from a “one-fits-all” principle to a more individualized approach.
Source: Memo - Magazine of European Medical Oncology - Category: Cancer & Oncology Source Type: research

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Purpose of review To report the available information on the current status and future direction of the use of checkpoint inhibitors as novel immunotherapeutic agents in bladder cancer. Recent findings In the past 3 years, five immunotherapies targeting programmed cell death 1 (Pembrolizumab and Durvalumab) or programmed cell death-ligand 1 (PD-L1) (Atezolizumab, nivolumab and Avelumab) pathways have been approved in second-line setting for patients who progressed during or after cisplatin-based chemotherapy. According to the most recent update, these patients should be PD-L1-positive to be eligible for immunotherapy....
Source: Current Opinion in Urology - Category: Urology & Nephrology Tags: BLADDER CANCER: Edited by Juan Palou and Óscar Rodríguez Faba Source Type: research
Condition:   Bladder Cancer Intervention:   Radiation: 15O-H2O PET/MR Sponsor:   Jørgen Bjerggaard Jensen Not yet recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Abstract Although surgery with curative intent is critical for management of many localized cancers, multimodal therapy including neoadjuvant and adjuvant therapy has been introduced to increase the effectiveness of local control of surgery and prolong survival. However, strong evidence supporting the utility of such multimodal therapy is limited. The utility of perioperative chemotherapy has been extensively investigated in bladder cancer, and several randomized controlled trials have indicated the benefit of neoadjuvant cisplatin-based chemotherapy in muscle-invasive bladder cancer. Regrettably, perioperative th...
Source: Clinical Prostate Cancer - Category: Cancer & Oncology Authors: Tags: Jpn J Clin Oncol Source Type: research
Conclusion: These updated French guidelines will contribute to increase the level of urological care for the diagnosis and treatment for NMIBC and MIBC. PMID: 32093463 [PubMed - in process]
Source: Progres en Urologie - Category: Urology & Nephrology Tags: Prog Urol Source Type: research
Authors: Regnier P, De Luca V, Brunelle S, Sfumato P, Walz J, Rybikowski S, Maubon T, Branger N, Fakhfakh S, Durand M, Gravis G, Pignot G Abstract BACKGROUND: Sarcopenia is suspected to influence the complication rates in patients undergoing radical cystectomy (RC). The aim of our study was to assess variations in sarcopenia in patients scheduled for neoadjuvant cisplatin-based chemotherapy (NAC) and RC for muscle invasive bladder cancer (MIBC) and to explore the impact of sarcopenia on complications linked to NAC or surgery. METHODS: Between 2012 and 2017, 82 consecutive patients who underwent NAC and RC for c...
Source: Minerva Urologica e Nefrologica - Category: Urology & Nephrology Tags: Minerva Urol Nefrol Source Type: research
ConclusionsAbsent or thin inner-layer enhancement on UP CT demonstrated high diagnostic performance and high inter-reader agreement for assessment of pCR after neoadjuvant chemotherapy in bladder cancer, and evaluation of this feature could improve the predictive ability of preoperative imaging for assessing pCR.
Source: European Journal of Radiology - Category: Radiology Source Type: research
This article discusses a novel approach that exploits cancer multidrug resistance to provide personalized phenotype-based therapy utilizing the MIBC NAC dilemma. PMID: 32049187 [PubMed - in process]
Source: Acta Cirurgica Brasileira - Category: Surgery Authors: Tags: Acta Cir Bras Source Type: research
CONCLUSION: Our study generates the hypothesis that NAC equalizes the preoperative disparity in pathologic stage between males and females suggesting a possible differential response between sexes. This might be the explanation underlying the comparable survival outcomes between sexes despite females presenting with more advanced tumor stage. PMID: 32057595 [PubMed - as supplied by publisher]
Source: Urologic Oncology - Category: Urology & Nephrology Authors: Tags: Urol Oncol Source Type: research
Authors: Jue JS, Koru-Sengul T, Miao F, Velásquez MC, Sávio LF, Alameddine M, Kroeger ZA, Punnen S, Parekh DJ, Ritch CR, Gonzalgo ML Abstract BACKGROUND: We compared survival outcomes among patients who received either NAC or AC and RC. METHODS: We identified patients in the National Cancer Data Base (NCDB) diagnosed with clinical T2-T4, N0, M0 urothelial carcinoma who underwent RC. Patients who received NAC were propensity matched by age, race, ethnicity, sex, insurance type, academic/research program, comorbidity, and clinical stage to patients receiving AC within 90 days of RC. Median survival ...
Source: Minerva Urologica e Nefrologica - Category: Urology & Nephrology Tags: Minerva Urol Nefrol Source Type: research
RARITAN, N.J., February 3, 2020 – The Janssen Pharmaceutical Companies of Johnson &Johnson announced today multiple data presentations from a robust solid tumor portfolio that will be featured at the American Society of Clinical Oncology Genitourinary (ASCO GU) Cancers Symposium, taking place February 13-15 in San Francisco. Company-sponsored data presentations will include clinical results for ERLEADA® (apalutamide) and niraparib in prostate cancer; and BALVERSA™ (erdafitinib) in bladder cancer. “We are committed to improving outcomes in patients with prostate and bladder cancer where high unmet ...
Source: Johnson and Johnson - Category: Pharmaceuticals Tags: Innovation Source Type: news
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