Contemporary management of muscle-invasive bladder cancer. Issue 7 (July 2012)

• Record Type: Journal Article
• Authors: Dall'Era, Marc A; Cheng, Liang; Pan, Chong-Xian
• Is Part Of: Expert review of anticancer therapy. Volume 12:Issue 7(2012)
• Page Start: 941
• Page End: 950
• Publication Date: 2012-07
• Subjects: bladder urothelial carcinoma -- chemotherapy -- cisplatin -- personalized chemotherapy -- targeted therapy; Cancer -- Treatment -- Periodicals; 616.99406
• DOI: 10.1586/era.12.60
• Languages: English
• ISSNs: 1473-7140

Abstract

The current standard treatment for muscle-invasive nonmetastatic bladder cancer is neoadjuvant platinum-based chemotherapy followed by radical cystectomy. However, neoadjuvant chemotherapy is not widely accepted even with level 1 evidence. Adjuvant chemotherapy should be discussed if patients have not received neoadjuvant chemotherapy before surgery and have high-risk pathologic features. Although not considered standard of care, bladder-sparing therapy can be considered for highly selected patients and for those medically unfit for surgery. Even though there are no level 1 data, the treatment outcomes for highly select patients given bladder-sparing therapy appear promising, with many patients retaining a functional bladder. Personalized chemotherapy is currently being actively pursued to target the underlying molecular changes and tailor to individual needs.