Efficacies and safety of neoadjuvant gemcitabine plus carboplatin followed by immediate cystectomy in patients with muscle-invasive bladder cancer, including those unfit for cisplatin: a prospective single-arm study

Abstract

Neoadjuvant GCarbo therapy followed by immediate RC is safe, even in cisplatin-unfit patients, and provides a favorable pathological cancer-free state. The single-arm single-institution study design and relatively short observation period were limitations of this study.

Oncological outcomes of neoadjuvant chemotherapy in patients with locally advanced upper tract urothelial carcinoma: A multicenter study.

“…The use of carboplatin in a neoadjuvant setting and the optimal number of courses still are being debated [15][16][17][18][19][20]. Because no evidence clearly supports the superiority of a cisplatin-based against a carboplatinbased regimen in a neoadjuvant setting in patients with UTUC [16,21], we designed a strategy including carboplatin-based NAC followed by immediate surgery in patients with UTUC and impaired renal function.…”

Risk-stratified surveillance and cost effectiveness of follow-up after radical cystectomy in patients with muscle-invasive bladder cancer.

“…The use of neoadjuvant chemotherapy (NAC) for patients with renal impairment remains unclear [29][30][31][32][33]. Based on several guidelines [34,35] NAC was not recommended in the patients with CKD (= cisplatin-unfit) and carboplatin-based regimen was believed less effective than cisplatin.…”

Gemcitabine and Carboplatin (Renally Dosed) Regimen for Bladder Cancer

“…7 The GCarbo regimen has also been studied as perioperative chemotherapy, specifically neoadjuvant chemotherapy, in locally advanced bladder cancer prior to cystectomy. 8,9 Current bladder cancer guidelines, however, recommend against the substitution of carboplatin for cisplatin in the setting of perioperative chemotherapy and suggest consideration of split-dose administration of cisplatin for patients with renal dysfunction, although efficacy of this adjustment remains unproven. 7 …”

“…In the trials reviewed, neutropenia was reported in 50% to 100% [1][2][3]6,8,9 of patients and grade 3 to 4 neutropenia in 7% to 70% [1][2][3][4][5][6]8,9 of patients. Febrile neutropenia was reported in 3% to 25% of patients.…”