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

Culine, Stéphane; Allory, Yves; Pfister, Christian

doi:10.21037/tau.2018.06.11

Cited by 4 publications

(3 citation statements)

References 15 publications

(13 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Despite the pivotal randomized studies and meta-analyses demonstrating the survival benefit of cisplatin-based combination chemotherapy before cystectomy [7,8], low implementation of this approach was observed in daily practice [9][10][11][12]. The objective of the French GETUG/AFU V05 Vesper phase III trial was to compare the efficacy of six cycles of dd-MVAC or four cycles of GC regimens (3 mo of chemotherapy) in terms of PFS in patients for whom chemotherapy has been decided, before or after radical cystectomy.…”

Section: Discussionmentioning

confidence: 99%

Randomized Phase III Trial of Dose-dense Methotrexate, Vinblastine, Doxorubicin, and Cisplatin, or Gemcitabine and Cisplatin as Perioperative Chemotherapy for Patients with Muscle-invasive Bladder Cancer. Analysis of the GETUG/AFU V05 VESPER Trial Secondary Endpoints: Chemotherapy Toxicity and Pathological Responses

et al. 2021

Self Cite

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Randomized Phase III Trial of Dose-dense Methotrexate, Vinblastine, Doxorubicin, and Cisplatin, or Gemcitabine and Cisplatin as Perioperative Chemotherapy for Patients with Muscle-invasive Bladder Cancer. Analysis of the GETUG/AFU V05 VESPER Trial Secondary Endpoints: Chemotherapy Toxicity and Pathological Responses

et al. 2021

Self Cite

View full text Add to dashboard Cite

“…15,16 The oncologic challenge was to refine the use of NAC with less toxic regimens for optimization in the perioperative setting. 17,18…”

Section: Discussionmentioning

confidence: 99%

“…15,16 The oncologic challenge was to refine the use of NAC with less toxic regimens for optimization in the perioperative setting. 17,18 Several retrospective studies reported divergent results regarding the relative efficacy of both regimens in the neoadjuvant setting. Van de Putte et al 19 investigated the efficacy and safety of neoadjuvant induction dd-MVAC with similar pathologic response and higher toxicity than GC chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

Dose-Dense Methotrexate, Vinblastine, Doxorubicin, and Cisplatin or Gemcitabine and Cisplatin as Perioperative Chemotherapy for Patients With Nonmetastatic Muscle-Invasive Bladder Cancer: Results of the GETUG-AFU V05 VESPER Trial

Pfister

Gravis

Fléchon

et al. 2022

JCO

Self Cite

View full text Add to dashboard Cite

PURPOSE The optimal perioperative chemotherapy regimen for patients with nonmetastatic muscle-invasive bladder cancer is not defined. PATIENTS AND METHODS Between February 2013 and March 2018, 500 patients were randomly assigned in 28 French centers and received either six cycles of dose-dense methotrexate, vinblastine, doxorubicin, and cisplatin (dd-MVAC) once every 2 weeks or four cycles of gemcitabine and cisplatin (GC) once every 3 weeks before surgery (neoadjuvant group) or after surgery (adjuvant group). We report the primary end point of the GETUG-AFU V05 VESPER trial (ClinicalTrials.gov identifier: NCT01812369 ): progression-free survival (PFS) at 3 years. Secondary end points were time to progression and overall survival. RESULTS Four hundred thirty-seven patients (88%) received neoadjuvant chemotherapy; 60% of patients received the planned six cycles in the dd-MVAC arm, 84% received four cycles in the GC arm, and thereafter, 91% and 90% of patients underwent surgery, respectively. Organ-confined response (< ypT3N0) was observed more frequently in the dd-MVAC arm (77% v 63%, P = .001). In the adjuvant group, 40% of patients received six cycles in the dd-MVAC arm, and 81% of patients received four cycles in the GC arm. For all patients in the clinical trial, 3-year PFS was improved in the dd-MVAC arm, but the study did not meet its primary end point (3-year rate: 64% v 56%, hazard ratio [HR] = 0.77 [95% CI, 0.57 to 1.02], P = .066); nevertheless, the dd-MVAC arm was associated with a significantly longer time to progression (3-year rate: 69% v 58%, HR = 0.68 [95% CI, 0.50 to 0.93], P = .014). In the neoadjuvant group, PFS at 3 years was significantly higher in the dd-MVAC arm (66% v 56%, HR = 0.70 [95% CI, 0.51 to 0.96], P = .025). CONCLUSION In the VESPER trial, dd-MVAC improved 3-years PFS over GC. In the neoadjuvant group, a better bladder tumor local control and a significant improvement in 3-year PFS were observed in the dd-MVAC arm.

show abstract

Comment on dose-dense methotrexate, vinblastine, doxorubicin, and cisplatin or gemcitabine and cisplatin as perioperative chemotherapy for patients with nonmetastatic muscle-invasive bladder cancer: Results of the GETUG-AFU V05 VESPER trial

Ren²,

Bao³

2023

Asian Journal of Surgery

View full text Add to dashboard Cite

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

Cited by 4 publications

References 15 publications

Dose-Dense Methotrexate, Vinblastine, Doxorubicin, and Cisplatin or Gemcitabine and Cisplatin as Perioperative Chemotherapy for Patients With Nonmetastatic Muscle-Invasive Bladder Cancer: Results of the GETUG-AFU V05 VESPER Trial

Comment on dose-dense methotrexate, vinblastine, doxorubicin, and cisplatin or gemcitabine and cisplatin as perioperative chemotherapy for patients with nonmetastatic muscle-invasive bladder cancer: Results of the GETUG-AFU V05 VESPER trial

Contact Info

Product

Resources

About