Neoadjuvant chemotherapy in urothelial bladder cancer: impact of regimen and variant histology. (August 2016)

• Record Type: Journal Article
• Authors: Kaimakliotis, Hristos Z; Monn, M Francesca; Cho, Jane S; Pedrosa, Jose A; Hahn, Noah M; Albany, Costantine; Gellhaus, Paul T; Cary, K Clint; Masterson, Timothy A; Foster, Richard S; Bihrle, Richard; Cheng, Liang; Koch, Michael O
• Is Part Of: Future oncology. Volume 12:Number 15(2016)
• Page Start: 1795
• Page End: 1804
• Publication Date: 2016-08
• Subjects: bladder cancer -- cystectomy -- downstaging -- neoadjuvant chemotherapy -- pathologic response -- variant histology; Oncology -- Periodicals; 616.99405
• DOI: 10.2217/fon-2016-0056
• Languages: English
• ISSNs: 1479-6694

Abstract

Aim: We compared the efficacy of methotrexate/vinblastine/doxorubicin/cisplatin (MVAC) versus gemcitabine/cisplatin in urothelial cancer and neoadjuvant chemotherapy (NACT) efficacy in variant histology (VH).Materials & methods: Radical cystectomy patients were retrospectively compared with those who received NACT. Factors associated with survival, pathologic complete response (pCR) and downstaging (pDS) were evaluated in multivariable models.Results: 9% of radical cystectomy patients (84/919) received NACT, with improved survival, pCR and pDS on both regimens. MVAC lead to higher pDS without an increase in pCR. On multivariable analysis, there was a nonsignificant increase in pDS with MVAC. NACT conferred similar responses in squamous and glandular differentiation VH.Conclusion: NACT was associated with improved survival, pCR and pDS. Furthermore, responses to NACT were not dependent on presence of VH.