(Neo)adjuvante chemotherapie bij spierinvasieve blaaskanker

Translated title of the contribution: (Neo) adjuvant chemotherapy in muscle invasive bladder cancer

Pieter de Mol, Winald R. Gerritsen

Research output: Contribution to journalArticlepeer-review

Abstract

At the time of diagnosis of bladder cancer 30 % is found to be muscle invasive. The prognosis of muscle invasive bladder cancer is poor en recurrence after radical systectomy is common. Bladder cancer is typically a disease of the elderly patient. Neoadjuvant chemotherapy for bladder cancer is administered to sterilize possible micrometastases at the time of diagnosis and thereby prevent recurrent disease. Neoadjuvant cisplatin-based chemotherapy is indicated for muscle invasive bladder cancer (≥ cT2) and results in a ten-year survival benefit of ±6 %. Cisplatin however is toxic and because of its toxicity it is often not suitable for the eldery patient with co-morbidity. When there is only limited lymphnode involvement, curation is possible with a dose dense chemotherapy scheme. Radiological responses are known to correlate poorly to pathologic responses after cystectomy. There are still to little robust data and adequately powered studies rendering evidence for adjuvant chemotherapy. Studies performed in the past unfortunately were terminated early due to poor accrual. New treatment modalities include immunotherapy and pembrolizumab, a monoclonal antibody directed against PD-1. Phase 1 studies show promising results with high response rates.

Translated title of the contribution(Neo) adjuvant chemotherapy in muscle invasive bladder cancer
Original languageDutch
Pages (from-to)215-222
Number of pages8
JournalTijdschrift voor Urologie
Volume5
Issue number8
DOIs
StatePublished - Dec 1 2015

Keywords

  • adjuvant chemotherapy
  • bladder cancer
  • immunotherapy
  • muscle invasive
  • neoadjuvant chemotherapy

ASJC Scopus subject areas

  • Urology

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