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J Urol: Which type of muscular invasive bladder cancer patients benefit the most from platinum-based neoadjuvant chemotherapy?

 Last Update: 2021-11-12
 Source: Internet
 Author: User

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Prior to radical cystectomy (RC) in patients with non-metastatic muscle invasive bladder cancer (MIBC), neoadjuvant cisplatin chemotherapy (NAC) can bring a 5-10% absolute overall survival (OS) benefit
.

Despite the first-level evidence and guideline recommendations, there are differences in the acceptance of NAC in clinical practice

The factors that affect the use of NAC involve the patient’s comorbidities, potential chemotherapy-related toxicity, the risk of disease progression in unresponsive patients, the delay in local treatment, and the choice of chemotherapy regimens.

There is evidence that molecular differences between tumors may affect the response to treatment
.

Therefore, clinically validated biomarkers can be used to predict the patient's response to NAC

Researchers from the United States published an article in "J Urol", investigating the benefits of different molecular subtypes of MIBC patients from NAC

The study included four bladder cancer cohorts
.

The inverse probability weighting method is used to make the baseline characteristics (age, gender, and clinical tumor stage) of the NAC treated group and the untreated group more comparable

A total of 601 MIBC patients were included in the study, of which 247 received NAC and RC treatment, and 354 received RC treatment but not NAC treatment
.

The results found that in patients using NAC, the overall net benefits of OS and CSS after three years were 7% and 5%, respectively

Patient's treatment results

In summary, among MIBC patients, non-luminal tumors have the greatest benefit from NAC, while patients with luminal tumors have the least survival benefit
.

Therefore, genomic classification tools may help identify MIBC patients who benefit the most from NAC

Among MIBC patients, non-luminal tumors have the greatest benefit from NAC, while patients with luminal tumors have the least survival benefit.

Original source:

Yair Lotan, Joep de Jong, Vinnie YT Liu et al.

Patients With Muscle Invasive Bladder Cancer with Non-luminal Subtype Derive Greatest Benefit from Platinum Based Neoadjuvant Chemotherapy

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