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)


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.


Bladder cancer Neoadjuvant therapy Surgery 



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.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. 1.
    Stein JP, Lieskovsky G, Cote R, et al. Radical cystectomy in the treatment of invasive bladder cancer: long-term results in 1,054 patients. J Clin Oncol. 2001;19:666–75.PubMedGoogle Scholar
  2. 2.
    Quek ML, Stein JP, Clark PE, et al. Natural history of surgically treated bladder carcinoma with extravesical tumor extension. Cancer. 2003;98:955–61.PubMedCrossRefGoogle Scholar
  3. 3.
    Shariat SF, Karakiewicz PI, Palapattu GS, et al. Outcomes of radical cystectomy for transitional cell carcinoma of the bladder: a contemporary series from the Bladder Cancer Research Consortium. J Urol. 2006;176:2414–22. discussion 22.PubMedCrossRefGoogle Scholar
  4. 4.
    Dowsett M, Smith IE, Ebbs SR, et al. Prognostic value of Ki67 expression after short-term presurgical endocrine therapy for primary breast cancer. J Natl Canc Inst. 2007;99:167–70.CrossRefGoogle Scholar
  5. 5.
    Mohsin SK, Weiss HL, Gutierrez MC, et al. Neoadjuvant trastuzumab induces apoptosis in primary breast cancers. J Clin Oncol. 2005;23:2460–8.PubMedCrossRefGoogle Scholar
  6. 6.
    Saxman SB, Propert KJ, Einhorn LH, et al. Long-term follow-up of a phase III intergroup study of cisplatin alone or in combination with methotrexate, vinblastine, and doxorubicin in patients with metastatic urothelial carcinoma: a cooperative group study. J Clin Oncol. 1997;15:2564–9.PubMedGoogle Scholar
  7. 7.
    von der Maase H, Sengelov L, Roberts JT, et al. Long-term survival results of a randomized trial comparing gemcitabine plus cisplatin, with methotrexate, vinblastine, doxorubicin, plus cisplatin in patients with bladder cancer. J Clin Oncol. 2005;23:4602–8.PubMedCrossRefGoogle Scholar
  8. 8.
    Sternberg CN, de Mulder PH, Schornagel JH, et al. Randomized phase III trial of high-dose-intensity methotrexate, vinblastine, doxorubicin, and cisplatin (MVAC) chemotherapy and recombinant human granulocyte colony-stimulating factor versus classic MVAC in advanced urothelial tract tumors: European Organization for Research and Treatment of Cancer Protocol no. 30924. J Clin Oncol. 2001;19:2638–46.PubMedGoogle Scholar
  9. 9.
    Bajorin DF, Dodd PM, Mazumdar M, et al. Long-term survival in metastatic transitional-cell carcinoma and prognostic factors predicting outcome of therapy. J Clin Oncol. 1999;17:3173–81.PubMedGoogle Scholar
  10. 10.
    Bellmunt J, von der Maase H, Mead GM, et al. Randomized phase III study comparing paclitaxel/cisplatin/gemcitabine (PCG) and gemcitabine/cisplatin (GC) in patients with locally advanced (LA) or metastatic (M) urothelial cancer without prior systemic therapy; EORTC30987/Intergroup Study. J Clin Oncol. (Meeting Abstracts). 2007 June 20, 2007;25:LBA5030-.Google Scholar
  11. 11.
    Bellmunt J, Theodore C, Demkov T, et al. Phase III trial of vinflunine plus best supportive care compared with best supportive care alone after a platinum-containing regimen in patients with advanced transitional cell carcinoma of the urothelial tract. J Clin Oncol. 2009;27:4454–61.PubMedCrossRefGoogle Scholar
  12. 12.
    Hussain MH, Wood DP, Bajorin DF, et al. Bladder cancer: narrowing the gap between evidence and practice. J Clin Oncol. 2009;27:5680–4.PubMedCrossRefGoogle Scholar
  13. 13.
    Dreicer R. Second-line chemotherapy for advanced urothelial cancer: because we should or because we can? J Clin Oncol. 2009;27:4444–5.PubMedCrossRefGoogle Scholar
  14. 14.
    Dash A, Galsky MD, Vickers AJ, et al. Impact of renal impairment on eligibility for adjuvant cisplatin-based chemotherapy in patients with urothelial carcinoma of the bladder. Cancer. 2006;107:506–13.PubMedCrossRefGoogle Scholar
  15. 15.
    Dogliotti L, Carteni G, Siena S, et al. Gemcitabine plus cisplatin versus gemcitabine plus carboplatin as first-line chemotherapy in advanced transitional cell carcinoma of the urothelium: results of a randomized phase 2 trial. Eur Urol. 2007;52:134–41.PubMedCrossRefGoogle Scholar
  16. 16.
    Petrioli R, Frediani B, Manganelli A, et al. Comparison between a cisplatin-containing regimen and a carboplatin-containing regimen for recurrent or metastatic bladder cancer patients. A randomized phase II study. Cancer. 1996;77:344–51.PubMedCrossRefGoogle Scholar
  17. 17.
    Bellmunt J, Ribas A, Eres N, et al. Carboplatin-based versus cisplatin-based chemotherapy in the treatment of surgically incurable advanced bladder carcinoma. Cancer. 1997;80:1966–72.PubMedCrossRefGoogle Scholar
  18. 18.
    Galsky MD, Chen GJ, Oh WK, et al. Comparative effectiveness of cisplatin-based and carboplatin-based chemotherapy for treatment of advanced urothelial carcinoma. Annals of oncology: official journal of the European Society for Medical Oncology/ESMO. 2011 May 4.Google Scholar
  19. 19.
    Grossman HB, Natale RB, Tangen CM, et al. Neoadjuvant chemotherapy plus cystectomy compared with cystectomy alone for locally advanced bladder cancer. N Engl J Med. 2003;349:859–66.PubMedCrossRefGoogle Scholar
  20. 20.
    Herr HW, Faulkner JR, Grossman HB, et al. Surgical factors influence bladder cancer outcomes: a cooperative group report. J Clin Oncol. 2004;22:2781–9.PubMedCrossRefGoogle Scholar
  21. 21.
    Neoadjuvant cisplatin, methotrexate, and vinblastine chemotherapy for muscle-invasive bladder cancer: a randomised controlled trial. International collaboration of trialists. Lancet. 1999 Aug 14;354:533–40.Google Scholar
  22. 22.
    •• Griffiths G, Hall R, Sylvester R, Raghavan D, Parmar MK. International phase III trial assessing neoadjuvant cisplatin, methotrexate, and vinblastine chemotherapy for muscle-invasive bladder cancer: long-term results of the BA06 30894 trial. J Clin Oncol Offic J Am Soc Clin Oncol. 2011 Jun 1;29:2171–7. This is the recent publication of an update of the MRC randomized phase III trial that evaluated neoadjuvant CMV and demonstrated improved survival. CrossRefGoogle Scholar
  23. 23.
    Malmstrom PU, Rintala E, Wahlqvist R, Hellstrom P, Hellsten S, Hannisdal E. Five-year follow-up of a prospective trial of radical cystectomy and neoadjuvant chemotherapy: nordic cystectomy trial I. The Nordic Cooperative Bladder Cancer Study Group. J Urol. 1996;155:1903–6.PubMedCrossRefGoogle Scholar
  24. 24.
    Sherif A, Rintala E, Mestad O, et al. Neoadjuvant cisplatin-methotrexate chemotherapy for invasive bladder cancer–Nordic cystectomy trial 2. Scand J Urol Nephrol. 2002;36:419–25.PubMedCrossRefGoogle Scholar
  25. 25.
    Neoadjuvant chemotherapy in invasive bladder cancer: update of a systematic review and meta-analysis of individual patient data advanced bladder cancer (ABC) meta-analysis collaboration. Eur Urol. 2005 Aug;48:202–5; discussion 5–6.Google Scholar
  26. 26.
    Dash A, Pettus JA, Herr HW, et al. A role for neoadjuvant gemcitabine plus cisplatin in muscle-invasive urothelial carcinoma of the bladder: a retrospective experience. Cancer. 2008;113:2471–7.PubMedCrossRefGoogle Scholar
  27. 27.
    Weight CJ, Garcia JA, Hansel DE, et al. Lack of pathologic down-staging with neoadjuvant chemotherapy for muscle-invasive urothelial carcinoma of the bladder: a contemporary series. Cancer. 2009;115:792–9.PubMedCrossRefGoogle Scholar
  28. 28.
    Smith DC, Mackler NJ, Dunn RL, et al. Phase II trial of paclitaxel, carboplatin and gemcitabine in patients with locally advanced carcinoma of the bladder. J Urol. 2008;180:2384–8. discussion 8.PubMedCrossRefGoogle Scholar
  29. 29.
    Smith DC, Grivas P, Daignault, et al. A phase II trial of neoadjuvant ABI-007, carboplatin and gemcitabine (ACG) in patients with locally advanced carcinoma of the bladder genitourinary cancer symposium 2011, Abstract 244.Google Scholar
  30. 30.
    deVere White RW, Lara Jr PN, Goldman B, et al. A sequential treatment approach to myoinvasive urothelial cancer: a phase II Southwest Oncology Group trial (S0219). J Urol. 2009;181:2476–80. discussion 80-1.PubMedCrossRefGoogle Scholar
  31. 31.
    Matin SF, Margulis V, Kamat A, et al. Incidence of downstaging and complete remission after neoadjuvant chemotherapy for high-risk upper tract transitional cell carcinoma. Cancer. Jul 1;116:3127–34.Google Scholar
  32. 32.
    • Sonpavde G, Goldman BH, Speights VO, et al. Quality of pathologic response and surgery correlate with survival for patients with completely resected bladder cancer after neoadjuvant chemotherapy. Cancer. 2009 Sep 15;115:4104–9. This is a retrospective analysis of the SWOG-8710 phase 3 trial that evaluated neoadjuvant MVAC and analyzed a variety of pathologic endpoints for association with survival. PubMedCrossRefGoogle Scholar
  33. 33.
    David KA, Milowsky MI, Ritchey J, Carroll PR, Nanus DM. Low incidence of perioperative chemotherapy for stage III bladder cancer 1998 to 2003: a report from the National Cancer Data Base. J Urol. 2007;178:451–4.PubMedCrossRefGoogle Scholar
  34. 34.
    Feifer A, Taylor J, Shouery M, et al. Multi-institutional quality-of-care initiative for nonmetastatic, muscle-invasive, transitional cell carcinoma of the bladder. J Clin Oncol. 2011;29 (suppl 7; abstr 240).Google Scholar
  35. 35.
    Skinner DG, Daniels JR, Russell CA, et al. The role of adjuvant chemotherapy following cystectomy for invasive bladder cancer: a prospective comparative trial. J Urol. 1991;145:459–64. discussion 64-7.PubMedGoogle Scholar
  36. 36.
    Lehmann J, Retz M, Wiemers C, et al. Adjuvant cisplatin plus methotrexate versus methotrexate, vinblastine, epirubicin, and cisplatin in locally advanced bladder cancer: results of a randomized, multicenter, phase III trial (AUO-AB 05/95). J Clin Oncol. 2005;23:4963–74.PubMedCrossRefGoogle Scholar
  37. 37.
    Freiha F, Reese J, Torti FM. A randomized trial of radical cystectomy versus radical cystectomy plus cisplatin, vinblastine and methotrexate chemotherapy for muscle invasive bladder cancer. J Urol. 1996;155:495–9. discussion 9-500.PubMedCrossRefGoogle Scholar
  38. 38.
    Studer UE, Bacchi M, Biedermann C, et al. Adjuvant cisplatin chemotherapy following cystectomy for bladder cancer: results of a prospective randomized trial. J Urol. 1994;152:81–4.PubMedGoogle Scholar
  39. 39.
    Lehmann J, Franzaring L, Thuroff J, Wellek S, Stockle M. Complete long-term survival data from a trial of adjuvant chemotherapy vs. control after radical cystectomy for locally advanced bladder cancer. BJU Int. 2006;97:42–7.PubMedCrossRefGoogle Scholar
  40. 40.
    Ruggeri EM, Giannarelli D, Bria E, et al. Adjuvant chemotherapy in muscle-invasive bladder carcinoma: a pooled analysis from phase III studies. Cancer. 2006;106:783–8.PubMedCrossRefGoogle Scholar
  41. 41.
    Millikan R, Dinney C, Swanson D, et al. Integrated therapy for locally advanced bladder cancer: final report of a randomized trial of cystectomy plus adjuvant M-VAC versus cystectomy with both preoperative and postoperative M-VAC. J Clin Oncol Offic J Am Soc Clin Oncol. 2001;19:4005–13.Google Scholar
  42. 42.
    Gofrit ON, Stadler WM, Zorn KC, et al. Adjuvant chemotherapy in lymph node positive bladder cancer. Urol Oncol. 2009;27:160–4.PubMedCrossRefGoogle Scholar
  43. 43.
    Jin JO, Lehmann J, Taxy J, et al. Phase II trial of adjuvant gemcitabine plus cisplatin-based chemotherapy in patients with locally advanced bladder cancer. Clin Genitourin Canc. 2006;5:150–4.CrossRefGoogle Scholar
  44. 44.
    Cognetti F, Ruggeri EM, Felici A, et al. Adjuvant chemotherapy (AC) with cisplatin + gemcitabine (CG) versus chemotherapy (CT) at relapse (CR) in patients (pts) with muscle-invasive bladder cancer (MIBC) submitted to radical cystectomy (RC). An Italian multicenter randomised phase III trial. J Clin Oncol. 2008;26(May 20 suppl; abstr 5023).Google Scholar
  45. 45.
    Paz-Ares LG, Solsona E, Esteban E, et al. Randomized phase III trial comparing adjuvant paclitaxel/gemcitabine/cisplatin (PGC) to observation in patients with resected invasive bladder cancer: results of the Spanish Oncology Genitourinary Group (SOGUG) 99/01 study. J Clin Oncol. 2010;28:18 s(suppl; abstr LBA4518).Google Scholar
  46. 46.
    Stadler WM, Lerner SP, Groshen S, et al. Phase III study of molecularly targeted adjuvant therapy in locally advanced urothelial cancer of the bladder based on p53 status. J Clin Oncol Offic J Am Soc Clin Oncol. 2011;29:3443–9.CrossRefGoogle Scholar
  47. 47.
    Svatek RS, Shariat SF, Lasky RE, et al. The effectiveness of off-protocol adjuvant chemotherapy for patients with urothelial carcinoma of the urinary bladder. Clin Canc Res Offic J Am Assoc Canc Res. Sep 1;16:4461–7.Google Scholar
  48. 48.
    Donat SM, Shabsigh A, Savage C, et al. Potential impact of postoperative early complications on the timing of adjuvant chemotherapy in patients undergoing radical cystectomy: a high-volume tertiary cancer center experience. Eur Urol. 2009;55:177–85.PubMedCrossRefGoogle Scholar
  49. 49.
    Sonpavde G, Khan MM, Svatek RS, et al. Prognostic risk stratification of pathological stage T2N0 bladder cancer after radical cystectomy. BJU International. Nov 19.Google Scholar
  50. 50.
    Sonpavde G, Shariat SF. Preoperative chemotherapy for bladder cancer: a standard waits to be optimally deployed. Cancer. 2011 Jul 5.Google Scholar
  51. 51.
    Kibel AS, Dehdashti F, Katz MD, et al. Prospective study of [18F]fluorodeoxyglucose positron emission tomography/computed tomography for staging of muscle-invasive bladder carcinoma. J Clin Oncol Offic J Am Soc Clin Oncol. 2009;27:4314–20.CrossRefGoogle Scholar
  52. 52.
    Smith SC, Baras AS, Dancik G, et al. A 20-gene model for molecular nodal staging of bladder cancer: development and prospective assessment. Lancet Oncol. Feb;12:137–43.Google Scholar
  53. 53.
    Karakiewicz PI, Shariat SF, Palapattu GS, et al. Precystectomy nomogram for prediction of advanced bladder cancer stage. Eur Urol. 2006;50:1254–60. discussion 61-2.PubMedCrossRefGoogle Scholar
  54. 54.
    Mitra AP, Datar RH, Cote RJ. Molecular pathways in invasive bladder cancer: new insights into mechanisms, progression, and target identification. J Clin Oncol. 2006;24:5552–64.PubMedCrossRefGoogle Scholar
  55. 55.
    Wu XR. Urothelial tumorigenesis: a tale of divergent pathways. Nat Rev Cancer. 2005;5:713–25.PubMedCrossRefGoogle Scholar
  56. 56.
    Hanahan D, Weinberg RA. The hallmarks of cancer. Cell. 2000;100:57–70.PubMedCrossRefGoogle Scholar
  57. 57.
    Campbell SC, Volpert OV, Ivanovich M, Bouck NP. Molecular mediators of angiogenesis in bladder cancer. Cancer Res. 1998;58:1298–304.PubMedGoogle Scholar
  58. 58.
    Wu X, Obata T, Khan Q, Highshaw RA, De Vere White R, Sweeney C. The phosphatidylinositol-3 kinase pathway regulates bladder cancer cell invasion. BJU Int. 2004;93:143–50.PubMedCrossRefGoogle Scholar
  59. 59.
    Oka N, Yamamoto Y, Takahashi M, Nishitani M, Kanayama HO, Kagawa S. Expression of angiopoietin-1 and -2, and its clinical significance in human bladder cancer. BJU Int. 2005;95:660–3.PubMedCrossRefGoogle Scholar
  60. 60.
    Tomlinson DC, Lamont FR, Shnyder SD, Knowles MA. Fibroblast growth factor receptor 1 promotes proliferation and survival via activation of the mitogen-activated protein kinase pathway in bladder cancer. Cancer Res. 2009;69:4613–20.PubMedCrossRefGoogle Scholar
  61. 61.
    Sanchez-Carbayo M, Socci ND, Lozano J, Saint F, Cordon-Cardo C. Defining molecular profiles of poor outcome in patients with invasive bladder cancer using oligonucleotide microarrays. J Clin Oncol. 2006;24:778–89.PubMedCrossRefGoogle Scholar
  62. 62.
    Mitra AP, Pagliarulo V, Yang D, et al. Generation of a concise gene panel for outcome prediction in urinary bladder cancer. J Clin Oncol. 2009;27:3929–37.PubMedCrossRefGoogle Scholar
  63. 63.
    Karam JA, Lotan Y, Karakiewicz PI, et al. Use of combined apoptosis biomarkers for prediction of bladder cancer recurrence and mortality after radical cystectomy. Lancet Oncol. 2007;8:128–36.PubMedCrossRefGoogle Scholar
  64. 64.
    Shariat SF, Tokunaga H, Zhou J, et al. p53, p21, pRB, and p16 expression predict clinical outcome in cystectomy with bladder cancer. J Clin Oncol. 2004;22:1014–24.PubMedCrossRefGoogle Scholar
  65. 65.
    Chan KS, Espinosa I, Chao M, et al. Identification, molecular characterization, clinical prognosis, and therapeutic targeting of human bladder tumor-initiating cells. Proc Natl Acad Sci U S A. 2009;106:14016–21.PubMedCrossRefGoogle Scholar
  66. 66.
    Lonn U, Lonn S, Friberg S, Nilsson B, Silfversward C, Stenkvist B. Prognostic value of amplification of c-erb-B2 in bladder carcinoma. Clin Cancer Res. 1995;1:1189–94.PubMedGoogle Scholar
  67. 67.
    Rochester MA, Patel N, Turney BW, et al. The type 1 insulin-like growth factor receptor is over-expressed in bladder cancer. BJU Int. 2007;100:1396–401.PubMedCrossRefGoogle Scholar
  68. 68.
    Chiang GJ, Billmeyer BR, Canes D, et al. The src-family kinase inhibitor PP2 suppresses the in vitro invasive phenotype of bladder carcinoma cells via modulation of Akt. BJU Int. 2005;96:416–22.PubMedCrossRefGoogle Scholar
  69. 69.
    Catto JW, Azzouzi AR, Rehman I, et al. Promoter hypermethylation is associated with tumor location, stage, and subsequent progression in transitional cell carcinoma. J Clin Oncol. 2005;23:2903–10.PubMedCrossRefGoogle Scholar
  70. 70.
    Blick C, Hall P, Pwint T, et al. Accelerated MVAC as neoadjuvant chemotherapy for patients with muscle invasive transitional cell carcinoma of the bladder. Genitourin Canc Symp. 2011;Abstract 235.Google Scholar
  71. 71.
    Mitra N, Monk JP, Pohar KS, et al. Early outcomes with neoadjuvant high-dose intensity methotrexate, binblastine, doxorubicin and cisplatin (HD-MVAC) or gemcitabine and cisplatin (G-C) in muscle-invasive urothelial carcinoma of the bladder: a single-institution experience genitourinar cancer symposium 2011, Abstract 280.Google Scholar
  72. 72.
    Chaudhary UB, Golshayan A, Brisendine A, et al. Phase II trial of neoadjuvant cisplatin, gemcitabine and bevacizumab followed by radical cystectomy (RC) in patients with muscle-invasive transitional cell carcinoma (TCC) of the bladder genitourinar cancer symposium 2011, Abstract 276.Google Scholar
  73. 73.
    Li X, Lewis MT, Huang J, et al. Intrinsic resistance of tumorigenic breast cancer cells to chemotherapy. J Natl Canc Inst. 2008;100:672–9.CrossRefGoogle Scholar
  74. 74.
    Sternberg CN, de Mulder P, Schornagel JH, et al. Seven year update of an EORTC phase III trial of high-dose intensity M-VAC chemotherapy and G-CSF versus classic M-VAC in advanced urothelial tract tumours. Eur J Cancer. 2006;42:50–4.PubMedCrossRefGoogle Scholar
  75. 75.
    Hussain SA, Stocken DD, Riley P, et al. A phase I/II study of gemcitabine and fractionated cisplatin in an outpatient setting using a 21-day schedule in patients with advanced and metastatic bladder cancer. Br J Cancer. 2004;91:844–9.PubMedGoogle Scholar
  76. 76.
    De Santis M, Bellmunt J, Mead G, et al. Randomized phase II/III trial assessing gemcitabine/carboplatin and methotrexate/carboplatin/vinblastine in patients with advanced urothelial cancer “unfit” for cisplatin-based chemotherapy: phase II—results of EORTC study 3098. J Clin Oncol. 2009;27:5634–9.PubMedCrossRefGoogle Scholar
  77. 77.
    Sonpavde G, Khan MM, Lerner SP, et al. Disease-free survival at 2 or 3 years correlates with 5-year overall survival of patients undergoing radical cystectomy for muscle invasive bladder cancer. J Urol. Feb;185:456–61.Google Scholar
  78. 78.
    Liakou CI, Kamat A, Tang DN, et al. CTLA-4 blockade increases IFNgamma-producing CD4 + ICOShi cells to shift the ratio of effector to regulatory T cells in cancer patients. Proc Natl Acad Sci U S A. 2008;105:14987–92.PubMedCrossRefGoogle Scholar
  79. 79.
    Pruthi RS, Nielsen M, Heathcote S, et al. A phase II trial of neoadjuvant erlotinib in patients with muscle-invasive bladder cancer undergoing radical cystectomy: clinical and pathological results. BJU International. Aug;106:349–56.Google Scholar
  80. 80.
    Takata R, Katagiri T, Kanehira M, et al. Predicting response to methotrexate, vinblastine, doxorubicin, and cisplatin neoadjuvant chemotherapy for bladder cancers through genome-wide gene expression profiling. Clin Cancer Res. 2005;11:2625–36.PubMedCrossRefGoogle Scholar
  81. 81.
    Takata R, Katagiri T, Kanehira M, et al. Validation study of the prediction system for clinical response of M-VAC neoadjuvant chemotherapy. Cancer Sci. 2007;98:113–7.PubMedCrossRefGoogle Scholar
  82. 82.
    Font A, Taron M, Gago JL, et al. BRCA1 mRNA expression and outcome to neoadjuvant cisplatin-based chemotherapy in bladder cancer. Annals of oncology: official journal of the European Society for Medical Oncology/ESMO. Jan;22:139–44.Google Scholar
  83. 83.
    Bellmunt J, Paz-Ares L, Cuello M, et al. Gene expression of ERCC1 as a novel prognostic marker in advanced bladder cancer patients receiving cisplatin-based chemotherapy. Ann Oncol. 2007;18:522–8.PubMedCrossRefGoogle Scholar
  84. 84.
    Williams PD, Cheon S, Havaleshko DM, et al. Concordant gene expression signatures predict clinical outcomes of cancer patients undergoing systemic therapy. Cancer Res. 2009;69:8302–9.PubMedCrossRefGoogle Scholar
  85. 85.
    Gallagher DJ, Milowsky MI, Ishill N, et al. Detection of circulating tumor cells in patients with urothelial cancer. Ann Oncol. 2009;20:305–8.PubMedCrossRefGoogle Scholar

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

Personalised recommendations