(Neo) adjuvant chemotherapy in muscle invasive bladder cancer

Pieter de Mol, Winald R. Gerritsen

Research output: Research - peer-reviewArticle

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
LanguageDutch
Pages215-222
Number of pages8
JournalTijdschrift voor Urologie
Volume5
Issue number8
DOIs
StatePublished - Dec 1 2015
Externally publishedYes

Fingerprint

Adjuvant Chemotherapy
Urinary Bladder Neoplasms
Muscles
Drug Therapy
Cisplatin
Neoplasm Micrometastasis
Poisons
Cystectomy
Immunotherapy
Monoclonal Antibodies
Morbidity
Recurrence
Survival
Therapeutics
pembrolizumab

Keywords

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

ASJC Scopus subject areas

  • Urology

Cite this

(Neo)adjuvante chemotherapie bij spierinvasieve blaaskanker. / de Mol, Pieter; Gerritsen, Winald R.

In: Tijdschrift voor Urologie, Vol. 5, No. 8, 01.12.2015, p. 215-222.

Research output: Research - peer-reviewArticle

de Mol P, Gerritsen WR. (Neo)adjuvante chemotherapie bij spierinvasieve blaaskanker. Tijdschrift voor Urologie. 2015 Dec 1;5(8):215-222. Available from, DOI: 10.1007/s13629-015-0104-1
de Mol, Pieter ; Gerritsen, Winald R./ (Neo)adjuvante chemotherapie bij spierinvasieve blaaskanker. In: Tijdschrift voor Urologie. 2015 ; Vol. 5, No. 8. pp. 215-222
@article{0d3e4ab2b4834041bc8772c7f3116a70,
title = "(Neo)adjuvante chemotherapie bij spierinvasieve blaaskanker",
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.",
keywords = "adjuvant chemotherapy, bladder cancer, immunotherapy, muscle invasive, neoadjuvant chemotherapy",
author = "{de Mol}, Pieter and Gerritsen, {Winald R.}",
year = "2015",
month = "12",
doi = "10.1007/s13629-015-0104-1",
volume = "5",
pages = "215--222",
journal = "Tijdschrift voor Urologie",
issn = "2211-3037",
publisher = "Springer Science + Business Media",
number = "8",

}

TY - JOUR

T1 - (Neo)adjuvante chemotherapie bij spierinvasieve blaaskanker

AU - de Mol,Pieter

AU - Gerritsen,Winald R.

PY - 2015/12/1

Y1 - 2015/12/1

N2 - 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.

AB - 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.

KW - adjuvant chemotherapy

KW - bladder cancer

KW - immunotherapy

KW - muscle invasive

KW - neoadjuvant chemotherapy

UR - http://www.scopus.com/inward/record.url?scp=84949190679&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84949190679&partnerID=8YFLogxK

U2 - 10.1007/s13629-015-0104-1

DO - 10.1007/s13629-015-0104-1

M3 - Article

VL - 5

SP - 215

EP - 222

JO - Tijdschrift voor Urologie

T2 - Tijdschrift voor Urologie

JF - Tijdschrift voor Urologie

SN - 2211-3037

IS - 8

ER -