Clinical Complete Response after Neoadjuvant Chemotherapy for Muscle-invasive Bladder Cancer: A Call for Standardized Assessments and Definitions

Jared S. Winoker, Christine W. Liaw, Matthew D. Galsky, Peter Wiklund, Reza Mehrazin

Research output: Contribution to journalReview article

Abstract

The ability to accurately determine a complete clinical response (cCR) to neoadjuvant chemotherapy (NAC) before cystectomy could have paradigm-shifting implications for the management of muscle-invasive bladder cancer. Level 1 evidence demonstrates that up to 40% of patients are downstaged to pT0 disease following NAC, presenting an intriguing opportunity to identify select patients who might be spared the morbidity of radical surgery. However, clinical investigations in this space are hindered by lack of a uniform approach to postchemotherapy restaging and a standardized definition of cCR. Patient summary: In this mini-review, we discuss the current limitations to restaging of muscle-invasive bladder cancer following neoadjuvant chemotherapy and their implications for personalized medicine and translational research. We conclude that there is an unmet need to optimize and standardize restaging evaluation and definitions of a complete clinical response.

Original languageEnglish (US)
Pages (from-to)627-629
Number of pages3
JournalEuropean Urology Focus
Volume6
Issue number4
DOIs
StatePublished - Jul 15 2020

Keywords

  • Bladder cancer
  • Bladder preservation
  • Clinical response
  • Muscle-invasive bladder cancer
  • Neoadjuvant chemotherapy

ASJC Scopus subject areas

  • Urology

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