scholarly journals Pre-treatment lymphocytopaenia is an adverse prognostic biomarker in muscle-invasive and advanced bladder cancer

2016 ◽  
Vol 27 (2) ◽  
pp. 294-299 ◽  
Author(s):  
N. Joseph ◽  
S.J. Dovedi ◽  
C. Thompson ◽  
J. Lyons ◽  
J. Kennedy ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Prognostic Biomarker ◽  
Advanced Bladder Cancer ◽  
Pre Treatment ◽  
Muscle Invasive

Pre-treatment Lymphocytopaenia is a Valid Adverse Prognostic Factor in Muscle-invasive and Advanced Bladder Cancer

2016 ◽  
Vol 28 (5) ◽  
pp. e11
Author(s):  
N. Joseph ◽  
C. Thompson ◽  
S. Dovedi ◽  
J. Lyons ◽  
T. Elliott ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Prognostic Factor ◽  
Adverse Prognostic Factor ◽  
Advanced Bladder Cancer ◽  
Pre Treatment ◽  
Muscle Invasive

Neoadjuvant Chemotherapy Plus Cystectomy Compared With Cystectomy Alone for Locally Advanced Bladder Cancer

2021 ◽  
pp. 141-146
Author(s):  
Vikram M. Narayan
Keyword(s):  
Adverse Effect ◽  
Overall Survival ◽  
Bladder Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Randomized Study ◽  
Locally Advanced ◽  
Common Adverse Effect ◽  
Advanced Bladder Cancer ◽  
Muscle Invasive

This study summarizes a landmark study on the role of neoadjuvant chemotherapy with methotrexate, vinblastine, doxorubicin, and cisplatin (M-VAC) in patients with muscle-invasive bladder cancer. This randomized study of M-VAC plus cystectomy versus cystectomy alone suggested improved overall survival in patients receiving neoadjuvant therapy. Severe granulocytopenia was a common adverse effect in the chemotherapy group, but no deaths were attributed to chemotherapy.

Results from BLASST-1 (Bladder Cancer Signal Seeking Trial) of nivolumab, gemcitabine, and cisplatin in muscle invasive bladder cancer (MIBC) undergoing cystectomy.

2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 439-439 ◽  
Author(s):  
Shilpa Gupta ◽  
Guru Sonpavde ◽  
Christopher J. Weight ◽  
Bradley Alexander McGregor ◽  
Sumati Gupta ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Phase Ii Trial ◽  
Molecular Subtypes ◽  
Alternative Hypothesis ◽  
Muscle Invasive Bladder Cancer ◽  
Sample Proportion ◽  
Pre Treatment ◽  
Grade 3 ◽  
Muscle Invasive ◽  
Clinical Trial Information

439 Background: Cisplatin-based neoadjuvant chemotherapy (NAC) in MIBC improves survival which correlates with pathologic response (PaR) at radical cystectomy (RC). The combination of immunotherapy and NAC may improve PaR and outcomes in MIBC. We tested the efficacy and safety of nivolumab (N) with gemcitabine-cisplatin (GC) as neoadjuvant therapy for MIBC in our phase II trial (NCT03294304). Methods: Eligible pts with MIBC (cT2-T4a, N≤1, M0) who were candidates for RC were enrolled. Pts received C (70mg/m2) IV on D1, G (1000mg/m2) on D1,D8 and N (360 mg) IV on D8 every 21 days for 4 cycles followed by RC within 8 weeks. The primary endpoint was PaR (≤pT1,N0). Secondary objectives were safety of GC+N and PFS at 2 years. The correlative objectives based on pre-treatment biopsies were correlation of PaR with 1) WGS 2) molecular subtypes of BC; 3) PD-L1 expression; 4) baseline TILs, CD3, CD8 and CD56.. Evaluable pts. should have received at least 1 dose of N. PaR will be summarized by the PaR rate as estimated by the sample proportion with exact 95% confidence intervals. We specified a null PaR of 0.35 and an alternative hypothesis of 0.55; we will reject the null hypothesis if at least 20 of 41 pts. have a PaR. Results: Between Feb 2018 and June 2019, 41 pts. were enrolled (cT2N0 90%, cT3N0 7%, cT4N1 3%); 2 patients refused surgery but were included in ITT population. PaR was observed in 27/41 pts. (65.8%), including pts with N1 disease. The combination was safe with manageable toxicities and no deaths from treatment. Majority of AEs were from GC; the overall rates of grade 3-4 AEs was 20%, majority being neutropenia, thrombocytopenia and renal insufficiency. Immune related AEs were seen in 3 patients, 2 had "adenitis" which wasymptomatic,1 pt developed Guillian Barre Syndrome after surgery, which resolved with IVIG; and none of them required steroids. There was no delay in time to RC and no unexpected surgical complications from treatment. Patients are being followed for progression and survival. Correlative work is ongoing. Conclusions: Neoadjuvant N+GC is safe and effective in MIBC with significant pathologic downstaging rates and no added toxicities or delay to surgery. Clinical trial information: NCT03294304.

1777 CENTROSOME AMPLIFICATION IN BLADDER WASHING CYTOLOGY SAMPLES MAY BECOME PROGNOSTIC BIOMARKER IN NON-MUSCLE INVASIVE BLADDER CANCER

2012 ◽  
Vol 187 (4S) ◽  
Author(s):  
Yoshihiro Miyachika ◽  
Yoshiaki Yamamoto ◽  
Hiroaki Matsumoto ◽  
June Nishijima ◽  
Yoshihisa Kawai ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Prognostic Biomarker ◽  
Centrosome Amplification ◽  
Invasive Bladder Cancer ◽  
Muscle Invasive Bladder Cancer ◽  
Muscle Invasive

Centrosome amplification in bladder washing cytology specimens is a useful prognostic biomarker for non-muscle invasive bladder cancer

2013 ◽  
Vol 206 (1-2) ◽  
pp. 12-18 ◽  
Author(s):  
Yoshihiro Miyachika ◽  
Yoshiaki Yamamoto ◽  
Hiroaki Matsumoto ◽  
Jun Nishijima ◽  
Yoshihisa Kawai ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Prognostic Biomarker ◽  
Centrosome Amplification ◽  
Invasive Bladder Cancer ◽  
Muscle Invasive Bladder Cancer ◽  
Muscle Invasive

scholarly journals Tolerability and Efficacy of Neoadjuvant Chemotherapy with a Tri-Weekly Interval Methotrexate, Doxorubicin, Vinblastine, and Cisplatin Regimen for Patients with Locally Advanced Bladder Cancer

2018 ◽  
Vol 11 (2) ◽  
pp. 450-460 ◽  
Author(s):  
Satoko Arai ◽  
Tomohiko Hara ◽  
Yoshiyuki Matsui ◽  
Keiichi Koido ◽  
Hironobu Hashimoto ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Locally Advanced ◽  
Survival Rates ◽  
Dose Intensity ◽  
Relapse Free Survival ◽  
Free Survival ◽  
Advanced Bladder Cancer ◽  
Grade 3 ◽  
Muscle Invasive

Objective: Compared with standard treatment, a modified tri-weekly MVAC (methotrexate, doxorubicin, vinblastine, and cisplatin) treatment regimen with a high cisplatin dose intensity shows good efficacy and lower toxicity. Thus, we retrospectively investigated the tolerability and efficacy of a modified tri-weekly MVAC neoadjuvant regimen. Methods: We analyzed 25 patients with locally advanced bladder cancer medicated by a modified tri-weekly MVAC neoadjuvant regimen that omits treatment on days 15 and 22. The efficacy and tolerability were assessed retrospectively. Results: The numbers of patients in clinical stages 2, 3, and 4 were 13 (52.0%), 1 (4.0%), and 11 (44.0%), respectively. Surgery could be performed on all patients. Five patients (20.0%) had no cancer remaining in their surgical specimens. Remaining non-muscle-invasive cancer without metastasis was observed in 7 patients (28.0%), and the total downstaging rate was 44.0%. The 5-year overall and relapse-free survival rates were 79.0 and 75.0%, respectively. The overall relative dose intensity was 0.90. Serious hematologic toxicities rated grade 3 or greater were leukopenia in 6 patients (24.0%) and anemia in 1 patient (4.0%). Conclusions: Sufficient efficacy and tolerability of a modified tri-weekly MVAC neoadjuvant regimen were suggested. Thus, tri-weekly modified MVAC may be an option for neoadjuvant chemotherapy of advanced bladder cancer.

Retrospective study of locally advanced bladder cancer in elderly patients

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 18523-18523
Author(s):  
F. El Karak ◽  
G. Bringeon ◽  
G. Kepenekian ◽  
A. Flechon ◽  
M. Ghosn ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Elderly Patients ◽  
Cardiac Failure ◽  
Metastatic Cancer ◽  
Locally Advanced ◽  
Lower Limbs ◽  
Acute Cardiac Failure ◽  
Metastatic Bladder Cancer ◽  
Advanced Bladder Cancer ◽  
Muscle Invasive

18523 Background: Bladder cancer is one of the most frequent tumors in elderly patients (pts). However, guidelines have not been established yet in this age group. Methods: We analyzed retrospectively pts aged 75 years or more, with muscle invasive or metastatic bladder cancer treated between January 2000 and June 2005, in three institutions in Lyon-France: Léon Bérard Center, Saint Luc Saint Joseph Hospital and Protestant Infirmary. Results: Data from 126 pts (81% male) were available: median age was 80 years (75–94). 99 pts had disease confined to the bladder, 19 confirmed metastatic cancer and 8 at least T2aM0 disease. 42% of pts had a history of superficial bladder cancer; 96% an urothelial carcinoma, 19% an associated in situ carcinoma. Of note, 33% of male pts had a concomitant prostate cancer. Median Performance Status, American Society of Anesthesia score and Charlson Comorbidity index were 1, 2 and 2.14 respectively. Cardiovascular comorbidities were the most common (42.8%). 87% of pts were taking medications; median number of drug intake was 4. We focused on pts with muscle invasive, non metastatic bladder cancer: 55 of 99 pts underwent surgery; 48 of them had external urinary diversion. Postoperative complications occurred in 34% of pts: evisceration (15%), sepsis, hemorrhage, acute cardiac failure, acute renal failure, pulmonary embolism (3.7% each), bowel obstruction and acute arterial thrombosis of lower limbs (1.8% each), and 2 immediate postoperative deaths. 16 pts received radiotherapy with a curative intent, 6 of them had chemoradiation. Mean irradiation dose and duration were respectively 56.4 Gy and 6.5 weeks. Toxicity occurred in 5 pts: 2 discontinuations for intolerance, 1 acute cardiac failure, 1 grade 3 thrombopenia, and 1 toxic death (intestinal perforation). The last 28 pts received palliative care. After a median follow up of 14 months, 33 operated pts and 3 pts treated by radiotherapy were still alive in complete remission. Disease free survival and median survival were 11.5 and 42 months in the surgical group respectively and 12 and 12 months in the radiotherapy group respectively. Conclusions: Treatment of locally advanced bladder cancer in the elderly carries significant morbidity and mortality. Oncogeriatric assessment benefit for individual management must be studied. No significant financial relationships to disclose.

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