Neoadjuvant induction dose-dense MVAC for muscle invasive bladder cancer: efficacy and safety compared with classic MVAC and gemcitabine/cisplatin

Putte, Elisabeth E. Fransen van de; Mertens, Laura S.; Meijer, Richard P.; Heijden, Michiel S. van der; Bex, Axel; Poel, Henk G. van der; Kerst, J. Martijn; Bergman, Andries M.; Horenblas, Simon; Rhijn, Bas W.G. van

doi:10.1007/s00345-015-1636-y

Cited by 46 publications

(39 citation statements)

References 21 publications

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“…Complete pathologic response rates observed with split schedule cisplatin in this study (17.5%) are similar to those in a recent multicenter, prospective trial of dose-dense GC (15%) in which patients received gemcitabine 2,500 mg/m 2 on day 1 and cisplatin 35 mg/m 2 on days 1 and 2 every 2 weeks [7]. However, these response rates should be viewed within the context of historical response rates from transurethral resection alone with immediate cystectomy (15%) [2], ddMVAC using CS cisplatin (26%-43%) [8], and from neoadjuvant immunotherapy (29%-32%) [9,10].…”

supporting

confidence: 74%

Efficacy of Split Schedule Versus Conventional Schedule Neoadjuvant Cisplatin-Based Chemotherapy for Muscle-Invasive Bladder Cancer

et al. 2019

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Neoadjuvant cisplatin‐based chemotherapy (NAC; 70 mg/m2) is standard of care for muscle‐invasive bladder carcinoma (MIBC). Many patients (pts) cannot receive cisplatin because of renal impairment, and administration of cisplatin 35 mg/m2 on day 1 + 8 or 1 + 2 (i.e., split schedule) is a commonly used alternative. In this retrospective analysis, we compared complete (pT0) and partial (

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supporting

confidence: 74%

Efficacy of Split Schedule Versus Conventional Schedule Neoadjuvant Cisplatin-Based Chemotherapy for Muscle-Invasive Bladder Cancer

et al. 2019

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“…Recently, there has also been the introduction of a shorter course of MVAC, entitled dose-dense or accelerated MVAC (ddMVAC or AMVAC) [4]. While cisplatin is the cornerstone of chemotherapy for bladder cancer, it is often substituted with the less nephrotoxic carboplatin in patients with renal insufficiency; however, oncologic outcomes have not been demonstrated to be equivalent to cisplatin [5, 6].…”

Section: Introductionmentioning

confidence: 99%

Effect of Neoadjuvant Chemotherapy on Renal Function following Radical Cystectomy: Is there a Meaningful Impact?

Chandrasekar

Pugashetti

Durbin‐Johnson

et al. 2016

BLC

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Objective: To evaluate the patterns of impact of neoadjuvant chemotherapy (NAC) on renal function across the initial year following treatment for muscle-invasive bladder cancer (MIBC) with radical cystectomy (RC).Methods: We reviewed the charts of 241 patients who underwent RC for urothelial carcinoma of the bladder between 2003-14 at our institution. Renal function was evaluated at multiple time points (pre-chemotherapy, pre-operatively, post-operatively, 6–12 months follow-up), and then classified by CKD staging. Univariable and multivariable logistic regression analyses were performed to determine relationship between NAC and change in CKD stage.Results: Of the 241 patients who underwent RC for urothelial carcinoma of the bladder, 66 (27%) received NAC and 175 (73%) did not. In multivariable analysis, NAC was significantly associated with a decrease of at least one CKD stage from baseline to post-op (p = 0.009), but not to the 6–12 months follow-up time point (p = 0.050). The loss of GFR in the NAC cohort occurs up-front with chemotherapy, but the peri-operative course is similar to those who underwent cystectomy alone. Of the 15 NAC patients (26.8%) who were Stage 3 CKD prior to chemotherapy, none progressed to a higher stage CKD.Conclusion: NAC is associated with an initial decline in GFR, which then remains stable through the first year following RC. Despite an initial insult, patients receiving NAC are not vulnerable to further deterioration. When appropriately selected, NAC does not appear to result in a clinically significant deterioration of renal function.

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“…These findings could result from the doubling of the cisplatin dose intensity and may suggest that an increase in pathological response rate could be achieved with ddMVAC in the neoadjuvant setting. However other single institution, retrospective series reported comparable outcomes of GC and ddMVAC regimens ( 11 , 12 ). Considering the retrospective, nonrandomized design of these studies, we must be guarded in drawing definitive conclusions for daily practice.…”

Section: What Is the Optimal Chemotherapy Regimen? A Need For Clarifimentioning

confidence: 88%

Refining the use of neoadjuvant chemotherapy in locally advanced bladder cancer: from conviction to optimization

Culine

Allory

Pfister

2018

Transl. Androl. Urol.

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Neoadjuvant induction dose-dense MVAC for muscle invasive bladder cancer: efficacy and safety compared with classic MVAC and gemcitabine/cisplatin

Cited by 46 publications

References 21 publications

Efficacy of Split Schedule Versus Conventional Schedule Neoadjuvant Cisplatin-Based Chemotherapy for Muscle-Invasive Bladder Cancer

Efficacy of Split Schedule Versus Conventional Schedule Neoadjuvant Cisplatin-Based Chemotherapy for Muscle-Invasive Bladder Cancer

Effect of Neoadjuvant Chemotherapy on Renal Function following Radical Cystectomy: Is there a Meaningful Impact?

Refining the use of neoadjuvant chemotherapy in locally advanced bladder cancer: from conviction to optimization

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