Conservative Management Following Complete Clinical Response to Neoadjuvant Chemotherapy of Muscle Invasive Bladder Cancer: Contemporary Outcomes of a Multi-Institutional Cohort Study

Mazza, P; Moran, George W.; Li, Gen; Robins, Dennis; Matulay, Justin T.; Herr, Harry W.; DeCastro, G. Joel; McKiernan, James M.; Anderson, Christopher B.

doi:10.1016/j.juro.2018.05.078

Cited by 52 publications

(27 citation statements)

References 27 publications

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“…Control group was treated with a conventional GC chemotherapy regimen (14). Ondansetron (15) (Fuan Pharmaceutical Group Ningbo Team Pharmaceutical Co., Ltd., Ningbo, China; batch number: H10960146) was orally administered before chemotherapy to stop vomiting, 1,000 mg/m 2 of gemcitabine (Harbin Gloria Pharmaceutical Co., Ltd., Harbin, China; batch number: H20040958) was infused intravenously for 2 h on the 1st, 8th and 15th days of each cycle, and 30 mg/m 2 of cisplatin (Yunnan Gejiu Biological Pharmaceutical Co., Ltd., Yunnan, China; batch number: H53021740) was infused intravenously for 2 h on the 2nd day.…”

Section: Methodsmentioning

confidence: 99%

Clinical efficacy and mechanism of Pralatrexate combined with Palbociclib Isethionate in treatment of bladder cancer patients

Wang

Song

2018

Oncol Lett

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The clinical efficacy and mechanism of Pralatrexate (PTX) combined with Palbociclib Isethionate (PAL) in the treatment of bladder cancer patients was investigated. A retrospective analysis of medical records of 82 bladder cancer patients admitted to Shengjing Hospital of China Medical University from February 2015 to February 2018 was performed. Patients treated with PTX combined with PAL served as study group (42 cases) and patients with conventional GC (gemcitabine plus cisplatin) chemotherapy regimen were the control group (40 cases). Changes in liver function indexes before and after treatment were observed, including alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), and total bilirubin (TBil). RT-qPCR was used for detection of relative expression levels of serum dihydrofolate reductase (DHFR) and vascular endothelial growth factor (VEGF) before and after treatment in the two groups. The clinical efficacy after treatment and adverse reactions during treatment were observed in the two groups. There was no significant difference in the clinical remission rate (RR) nor in the serum ALT, AST, ALP and TBil levels between the study and the control groups (P>0.05). Concentrations of serum ALT, AST, ALP and TBil were significantly higher than those before treatment in both groups (P<0.05). Serum ALT, AST, ALP and TBil concentrations in study group were significantly lower than those in control group (P<0.05). There was no significant difference in the incidence of thrombocytopenia and leukopenia between the two groups (P>0.05). There was no significant difference in relative expression levels of serum DHFR mRNA and VEGF mRNA before treatment between the study and control groups (P>0.05). Those after treatment were significantly lower than those before treatment in both groups (P<0.05), and those after treatment in study group were significantly lower than those in control group (P<0.05). PTX combined with PAL can reduce adverse reactions of nausea and vomiting and liver function impairment during treatment and suppress tumor neovascularization. This is achieved possibly by inhibiting expression levels of DHFR and VEGF, thereby killing cancer cells. PTX combined with PAL may become a new method for the treatment of bladder cancer patients. DHFR and VEGF are expected to become novel therapeutic targets for the treatment of bladder cancer.

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Section: Methodsmentioning

confidence: 99%

Clinical efficacy and mechanism of Pralatrexate combined with Palbociclib Isethionate in treatment of bladder cancer patients

Wang

Song

2018

Oncol Lett

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“…The standard of care for patients who achieve complete clinical response (CR, defined as absence of disease on urinary cytology, TURBT and imaging) following NAC is to proceed with planned local definitive therapy. Retrospective data have reported 5year disease-free survival reaching 50-80% in these patients opting for surveillance [132][133][134][135], however supporting evidence is limited and discrepancy between CR defined by clinical staging and pCR limits the reliability of CR [86,136]. Ongoing work is exploring a risk adapted approach of selecting certain patients for active surveillance (NCT02710 734, NCT03609216).…”

Section: Complete Clinical Response Following Nacmentioning

confidence: 99%

Current Management of Localized Muscle-Invasive Bladder Cancer: A Consensus Guideline from the Genitourinary Medical Oncologists of Canada

Jiang

North

Canil

et al. 2020

BLC

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BACKGROUND: Despite recent advances in the management of muscle-invasive bladder cancer (MIBC), treatment outcomes remain suboptimal, and variability exists across current practice patterns. OBJECTIVE: To promote standardization of care for MIBC in Canada by developing a consensus guidelines using a multidisciplinary, evidence-based, patient-centered approach who specialize in bladder cancer. METHODS: A comprehensive literature search of PubMed, Medline, and Embase was performed; and most recent guidelines from national and international organizations were reviewed. Recommendations were made based on best available evidence, and strength of recommendations were graded based on quality of the evidence. RESULTS: Overall, 17 recommendations were made covering a broad range of topics including pathology review, staging investigations, systemic therapy, local definitive therapy and surveillance. Of these, 10 (59% ) were level 1 or 2, 7 (41% ) were level 3 or 4 recommendations. There were 2 recommendations which did not reach full consensus, and were based on majority opinion. This guideline also provides guidance for the management of cisplatin-ineligible patients, variant histologies, and bladder-sparing trimodality therapy. Potential biomarkers, ongoing clinical trials, and future directions are highlighted. CONCLUSIONS: This guideline embodies the collaborative expertise from all disciplines involved, and provides guidance to further optimize and standardize the management of MIBC.

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“…Additionally, disease recurrence has been reported in a subset of patients initially diagnosed with pCR highlighting the need to identify patients who present with occult metastasis at the time of surgery, as they could benefit from active surveillance and additional therapy to prevent disease recurrence. There is a critical need to identify those patients who can safely avoid surgery following neoadjuvant therapy, as well as those who need follow-up and additional therapy 11,12,13 . In this review we will discuss several emerging platforms that have strong potential to address these needs.…”

Section: Introductionmentioning

confidence: 99%

Emerging Roles of Urine-Derived Components for the Management of Bladder Cancer: One Man’s Trash is Another Man’s Treasure

Minkler¹,

Lucien²,

Kimber³

et al. 2020

Preprint

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Urinary bladder cancer (UBC) is the most common malignancy of the urinary tract in humans, with an estimated global prevalence of 1.1 million cases over 5 years1. Due to high rates of recurrence and resistance to chemotherapy, UBC is one of the most expensive cancers to treat, resulting in significant health care costs. There is, therefore, a critical need to develop innovative molecular and cellular tools to refine patient stratification and help predict response to treatment. Urine is an underused resource of biological components shed from bladder tumors, such as exfoliated cells and extracellular vesicles, that could serve as molecular fingerprints and provide valuable biological insights into tumor phenotype and mechanisms of resistance to chemotherapy. Additionally, characterization of urine-derived extracellular vesicles and cells could be used as reliable biomarkers for prediction of response to neoadjuvant therapy.

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Conservative Management Following Complete Clinical Response to Neoadjuvant Chemotherapy of Muscle Invasive Bladder Cancer: Contemporary Outcomes of a Multi-Institutional Cohort Study

Cited by 52 publications

References 27 publications

Clinical efficacy and mechanism of Pralatrexate combined with Palbociclib Isethionate in treatment of bladder cancer patients

Clinical efficacy and mechanism of Pralatrexate combined with Palbociclib Isethionate in treatment of bladder cancer patients

Current Management of Localized Muscle-Invasive Bladder Cancer: A Consensus Guideline from the Genitourinary Medical Oncologists of Canada

Emerging Roles of Urine-Derived Components for the Management of Bladder Cancer: One Man’s Trash is Another Man’s Treasure

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