Medical Professionals Online

New Drug Development In Bladder Cancer: Understanding Biology To Develop Future Leads

June 17, 2017

UroToday - Chemotherapy is effective in both locally advanced and metastatic bladder cancer. Two randomized trials have demonstrated that preoperative administration of Methotrexate, Vinblastine, Adriamycin, Cisplatin (MVAC) or Cisplatin, Methotrexte,Vinblastine (CMV) improve survival in patients with muscle invasive transitional cell carcinoma of the bladder. Other advantages of neoadjuvant therapy include the in vivo demonstration of chemosensitivity/resistance, pathological downstaging, and the possibility of bladder preservation. Of the 38% of patients who achieve Po status post cystectomy, 85% are alive at 5 years. Post cystectomy patients who have poor risk features including positive lymph nodes or invasion into the perivesical fat have 5 year survivals ranging between 5 and 30%, there has not been an adequately powered adjuvant trial demonstrating a survival benefit for chemotherapy.

Only 20-30% of metastatic patients treated with cisplatin based chemotherapy initially have a complete response to treatment; the long term survival rate is