Guideline on Muscle-Invasive and Metastatic Bladder Cancer (European Association of Urology Guideline): American Society of Clinical Oncology Clinical Practice Guideline Endorsement

Milowsky, Matthew I.; Rumble, R. Bryan; Booth, Christopher M.; Gilligan, Timothy D.; Eapen, Libni; Hauke, Ralph J.; Boumansour, Pat; Lee, Cheryl T.

doi:10.1200/jco.2015.65.9797

Cited by 210 publications

(135 citation statements)

References 11 publications

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“…Single-arm, phase II trials with paclitaxel, carboplatin, and gemcitabine 42,91 , as well as nab-paclitaxel, carboplatin, and gemcitabine 92 , have yielded pathological responses, but at rates less than those expected with the use of cisplatin-based chemotherapy and with higher incidences of haematological toxicity. Current guidelines suggest that non-cisplatin-based chemotherapy should only be considered when downstaging of surgically unresectable tumours is the primary objective 13 .…”

Section: Improving On Standard Nact With Mvacmentioning

confidence: 99%

“…In this Review, we describe the evolution of the chemotherapy landscape in the perioperative treatment of MIBC. Neoadjuvant cisplatin-based chemotherapy has emerged as a standard of care 10–13 , although many patients do not benefit from this approach 14,15 . Therefore, we highlight advances in genomic profiling that might result in more-individualized treatment that could improve outcomes.…”

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confidence: 99%

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Systemic, perioperative management of muscle-invasive bladder cancer and future horizons

2016

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Many patients diagnosed with muscle-invasive bladder cancer (MIBC) will develop distant metastatic disease. Over the past three decades, perioperative cisplatin-based chemotherapy has been investigated for its ability to reduce the number of deaths from bladder cancer. Insufficient evidence is available to fully support the use of such chemotherapy in the adjuvant setting; however, neoadjuvant cisplatin-based combination chemotherapy has become a standard of care for eligible patients based on the improved disease-specific and overall survival demonstrated in two randomized phase III trials, compared with surgery alone. For patients with disease downstaging to non-MIBC at the time of radical cystectomy as a result of neoadjuvant chemotherapy, outcomes are outstanding, with 5-year overall survival of 80–90%. Nevertheless, the inability to define before treatment the patients who will and those who will not achieve such a response has impeded the achievement of better outcomes for patients with MIBC. High-throughput DNA and RNA profiling technologies might help to overcome this barrier and enable a more-personalized approach to the use of cytotoxic neoadjuvant chemotherapy. In the past 2 years, trial results have demonstrated the unprecedented ability of immune-checkpoint blockade to induce durable remissions in patients with metastatic disease that has progressed after chemotherapy; studies are now urgently needed to determine how best to incorporate this powerful therapeutic modality into the care of patients with MIBC. Herein, we review the evolution of chemotherapy and immunotherapy for muscle-invasive bladder cancer.

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Section: Improving On Standard Nact With Mvacmentioning

confidence: 99%

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confidence: 99%

Systemic, perioperative management of muscle-invasive bladder cancer and future horizons

2016

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“…45 Despite this, guidelines still do not recommend routine adjuvant chemotherapy postradical cystectomy in patients with UCB; instead its use is only recommended for high-risk patients such as those with nodal disease. 46 Comparatively, for UTUC the best evidence for supporting adjuvant chemotherapy comes from a meta-analysis of nine retrospective cohort studies. 47 A total of 482 patients received adjuvant chemotherapy compared with 1300 patients receiving surgery alone for UTUC; this showed an overall survival benefit favouring the former, with an HR of 0.43 (95% CI 0.21 to 0.89, p=0.023) and a disease-free survival benefit with a pooled HR of 0.49 (95% CI 0.24 to 0.99, p=0.048).…”

Section: Medical Management: Adjuvant Chemotherapymentioning

confidence: 99%

Upper tract urothelial carcinoma: a different disease entity in terms of management

et al. 2016

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Upper tract urothelial carcinomas (UTUCs) consist of 5%–10% of all urothelial carcinomas, the rest being urothelial carcinomas of the bladder (UCB). There is increasing evidence to show that UTUC is a distinct disease entity from UCB based on phenotypical and genotypical (genetic and epigenetic) differences. This may account for why the natural history of UTUC is different from that of UCB, with >60% of UTUCs and only 15%–25% of UCB presenting with invasion at diagnosis. Management of UTUC is thus different from UCB in a variety of ways, ranging from surgical management, postoperative instillation therapy, postoperative surveillance and medical management (neoadjuvant and adjuvant chemotherapy). This review paper aims to highlight these differences with an emphasis on the distinct management of UTUC, along with the latest updates.

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“…A non-invasive assay would provide significant benefits for patient comfort, with urine as an ideal sample for bladder cancer diagnosis and follow-ups due to the ease of obtaining patient samples in a non-invasive manner [9]. Based on established guidelines, it is currently not recommended to test urinary biomarkers in place of cystoscopy [16,17,62].…”

Section: Invasive Techniquesmentioning

confidence: 99%

Microdevices for Non-Invasive Detection of Bladder Cancer

et al. 2017

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Bladder cancer holds the record for the highest lifetime cost on a per-patient basis. This is due to high recurrence rates, which necessitate invasive and costly long-term evaluation methods such as cystoscopy and imaging. Microfluidics is emerging as an important approach to contribute to initial diagnosis and follow-up, by enabling the precise manipulation of biological samples. Specifically, microdevices have been used for the isolation of cells or genetic material from blood samples, sparking significant interest as a versatile platform for non-invasive bladder cancer detection with voided urine. In this review, we revisit the methods of bladder cancer detection and describe various types of markers currently used for evaluation. We detail cutting-edge technologies and evaluate their merits in the detection, screening, and diagnosis of bladder cancer. Advantages of microscale devices over standard methods of detection, as well as their limitations, are provided. We conclude with a discussion of criteria for guiding microdevice development that could deepen our understanding of prognoses at the level of individual patients and the underlying biology of bladder cancer development. Collectively, the development and widespread application of improved microfluidic devices for bladder cancer could drive treatment breakthroughs and establish widespread, tangible outcomes on patients' long-term survival.

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Guideline on Muscle-Invasive and Metastatic Bladder Cancer (European Association of Urology Guideline): American Society of Clinical Oncology Clinical Practice Guideline Endorsement

Cited by 210 publications

References 11 publications

Systemic, perioperative management of muscle-invasive bladder cancer and future horizons

Systemic, perioperative management of muscle-invasive bladder cancer and future horizons

Upper tract urothelial carcinoma: a different disease entity in terms of management

Microdevices for Non-Invasive Detection of Bladder Cancer

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