Current Urology Reports

, Volume 13, Issue 2, pp 136–146 | Cite as

Neoadjuvant Chemotherapy for Invasive Bladder Cancer

Bladder and Urothelial Cancer (A Sagalowsky, Section Editor)

Abstract

Neoadjuvant cisplatin-based combination chemotherapy is an established standard for resectable muscle-invasive bladder cancer, a disease with a pattern of predominantly distant and early recurrences. Pathologic complete remission appears to be an intermediate surrogate for survival when employing combination chemotherapy. Moreover, baseline host and tumor tissue studies may enable the discovery of biomarkers predictive of activity. The neoadjuvant setting also provides a window of opportunity to evaluate novel biologic agents or rational combinations of biologic agents to obtain a signal of biologic activity. The residual tumor after neoadjuvant therapy may be exploited to study the mechanism of action and resistance. Cisplatin-ineligible patients warrant the evaluation of tolerable neoadjuvant regimens. Given that bladder cancer is characterized by initial localized presentation in the vast majority of cases, the paradigm of neoadjuvant therapy may expedite the development of novel systemic agents.

Keywords

Bladder cancer Neoadjuvant therapy Surgery 

Notes

Disclosures

Dr. Guru Sonpavde has served as board member for Novartis, Bristol-Myers Squibb, Pfizer, Dendreon, and Janssen; has received grants or research support or has grants pending from Cephalon, Celgene, Bristol-Myers Squibb, Pfizer, Bellicum Pharmaceuticals, Ascenta Therapeutics, Novartis, Cytogen, AstraZeneca, and Imclone-Eli Lilly; and has received honoraria from Wyeth/Pfizer, Novartis, Sanofi-Aventis, GlaxoSmithKline, Janssen Biotech, Dendreon, and Amgen. Dr. Cora Sternberg has received honoraria from Novartis, Pfizer, and GlaxoSmithKline; has received research support from Sanofi- Aventis, Cougar Biotech, and Astellas; and served on the advisory board or as a consultant for Bayer, Novartis, GlaxoSmithKline and Pfizer.

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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Texas Oncology, the Michael E. DeBakey Veterans Affairs Medical Center, Department of MedicineSection of Medical Oncology, Baylor College of MedicineHoustonUSA
  2. 2.San Camillo and Forlanini Hospitals, Padiglione Flajani IRomeItaly

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