scholarly journals Systemic Chemotherapy for Urothelial Cancer – How to Select Systemic Therapy in Bladder Cancer

2017 ◽  
Vol 13 (02) ◽  
pp. 134 ◽  
Author(s):  
Ioannis Dimitriadis ◽  
Aristotelis Bamias ◽  
◽  
Keyword(s):  
Bladder Cancer ◽  
Adjuvant Chemotherapy ◽  
Disease Management ◽  
Systemic Therapy ◽  
Survival Benefit ◽  
Systemic Chemotherapy ◽  
Urothelial Cancer ◽  
Advanced Disease ◽  
Early Disease ◽  
Chemotherapy Adjuvant

Urothelial cancer (UC) has long been recognised as a chemosensitive disease, and systemic chemotherapy plays a crucial role in the management of localised and advanced disease. Unfortunately, there has been a paucity of progress during the last 15 years in this area. Neoadjuvant use of cisplatin-based combinations has shown survival benefit and together with radical cystectomy should constitute the cornerstone of early disease management. Most importantly, Galsky criteria concerning fitness for cisplatin provide a useful tool for clinicians, in order to select patients with substantial benefit from cisplatin-based chemotherapy. Adjuvant chemotherapy may be useful in selected cases, but its wide implementation has to be proved. Recently, the advent of modern immunotherapy seems to offer new effective choices for patients with advanced UC.

Systemic Therapy for Invasive Bladder Cancer

1996 ◽  
Vol 3 (6) ◽  
pp. 501-506 ◽  
Author(s):  
Milind Javle ◽  
Derek Raghavan
Keyword(s):  
Bladder Cancer ◽  
Survival Benefit ◽  
Systemic Chemotherapy ◽  
Systemic Treatment ◽  
Superficial Bladder Cancer ◽  
Locally Advanced ◽  
Local Therapy ◽  
The United States ◽  
Invasive Disease ◽  
Western Society

Background Bladder cancer is one of the most common malignancies in Western society. In the United States, approximately 10,000 of these patients present with invasive disease, and more progress from superficial bladder cancer. Methods The authors review the literature on systemic treatment for both localized and metastatic bladder cancer, and they include their experience in defining approaches to various stages of disease. Results Cisplatin-based combination chemotherapy is the most effective systemic approach for advanced bladder cancers, although few patients are cured. Neoadjuvant, perspective, and adjuvant trials, as well as concurrent chemoradiation studies, are in progress to attempt to demonstrate better outcomes. Conclusions The combination of systemic chemotherapy and definitive local therapy may have a useful role in the management of locally advanced bladder cancers, but optimal schedules and true survival benefit have not been established.

Survival Benefit Persists With Delayed Initiation of Adjuvant Chemotherapy Following Radical Cystectomy for Locally Advanced Bladder Cancer

Urology ◽  
2019 ◽  
Vol 132 ◽  
pp. 143-149 ◽  
Author(s):  
Christopher J. Corbett ◽  
Leilei Xia ◽  
Ronac Mamtani ◽  
Stanley Bruce Malkowicz ◽  
Thomas J. Guzzo
Keyword(s):  
Bladder Cancer ◽  
Adjuvant Chemotherapy ◽  
Radical Cystectomy ◽  
Survival Benefit ◽  
Locally Advanced ◽  
Advanced Bladder Cancer ◽  
Delayed Initiation

Pathological factors associated with survival benefit from adjuvant chemotherapy (ACT): a population-based study of bladder cancer

2014 ◽  
Vol 116 (3) ◽  
pp. 373-381 ◽  
Author(s):  
Christopher M. Booth ◽  
D. Robert Siemens ◽  
Xuejiao Wei ◽  
Yingwei Peng ◽  
David M. Berman ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Adjuvant Chemotherapy ◽  
Survival Benefit ◽  
Population Based ◽  
Population Based Study ◽  
Factors Associated

Pathways Forward in Candidate Selection for Systemic Therapy in Invasive Urothelial Cancer of the Bladder

2016 ◽  
Vol 12 (01) ◽  
pp. 49
Author(s):  
Debasish Sundi ◽  
Keyword(s):  
Overall Survival ◽  
Bladder Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Radical Cystectomy ◽  
Systemic Therapy ◽  
Urothelial Cancer ◽  
Candidate Selection ◽  
Invasive Bladder Cancer ◽  
Cancer Of The Bladder ◽  
Selection For

Neoadjuvant chemotherapy (NAC) prior to radical cystectomy improves overall survival for patients with invasive bladder cancer, compared to patients undergoing radical cystectomy alone. However, only a subset of patients benefit from NAC. This editorial highlights recent and emerging developments that aim to identify optimal NAC candidates.

scholarly journals Sex Hormone Receptor Signaling in Bladder Cancer: A Potential Target for Enhancing the Efficacy of Conventional Non-Surgical Therapy

Cells ◽  
2021 ◽  
Vol 10 (5) ◽  
pp. 1169
Author(s):  
Hiroki Ide ◽  
Hiroshi Miyamoto
Keyword(s):  
Bladder Cancer ◽  
Estrogen Receptor ◽  
Androgen Receptor ◽  
Surgical Therapy ◽  
Urothelial Cancer ◽  
Hormone Receptors ◽  
Estrogen Receptor Α ◽  
Vital Role ◽  
Sex Hormone ◽  
Sex Steroid Hormone

There have been critical problems in the non-surgical treatment for bladder cancer, especially residence to intravesical pharmacotherapy, including BCG immunotherapy, cisplatin-based chemotherapy, and radiotherapy. Recent preclinical and clinical evidence has suggested a vital role of sex steroid hormone-mediated signaling in the progression of urothelial cancer. Moreover, activation of the androgen receptor and estrogen receptor pathways has been implicated in modulating sensitivity to conventional non-surgical therapy for bladder cancer. This may indicate the possibility of anti-androgenic and anti-estrogenic drugs, apart from their direct anti-tumor activity, to function as sensitizers of such conventional treatment. This article summarizes available data suggesting the involvement of sex hormone receptors, such as androgen receptor, estrogen receptor-α, and estrogen receptor-β, in the progression of urothelial cancer, focusing on their modulation for the efficacy of conventional therapy, and discusses their potential of overcoming therapeutic resistance.

Combination of AST to ALT and neutrophils to lymphocytes ratios as predictors of locally advanced disease in patients with bladder cancer subjected to radical cystectomy: Results from a single-institutional series

2021 ◽  
pp. 039156032110351
Author(s):  
Alessandro Uleri ◽  
Rodolfo Hurle ◽  
Roberto Contieri ◽  
Pietro Diana ◽  
Nicolòmaria Buffi ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Radical Cystectomy ◽  
Advanced Disease ◽  
Independent Predictor ◽  
Small Sample Size ◽  
Statistical Significance ◽  
Locally Advanced ◽  
Small Sample ◽  
Locally Advanced Disease ◽  
Increased Risk

Background: Bladder cancer (BC) staging is challenging. There is an important need for available and affordable predictors to assess, in combination with imaging, the presence of locally-advanced disease. Objective: To determine the role of the De Ritis ratio (DRR) and neutrophils to lymphocytes ratio (NLR) in the prediction of locally-advanced disease defined as the presence of extravescical extension (pT ⩾ 3) and/or lymph node metastases (LNM) in patients with BC treated with radical cystectomy (RC). Methods: We retrospectively analyzed clinical and pathological data of 139 consecutive patients who underwent RC at our institution. Logistic regression models (LRMs) were fitted to test the above-mentioned outcomes. Results: A total of 139 consecutive patients underwent RC at our institution. Eighty-six (61.9%) patients had a locally-advanced disease. NLR (2.53 and 3.07; p = 0.005) and DRR (1 and 1.17; p = 0.01) were significantly higher in patients with locally-advanced disease as compared to organ-confined disease. In multivariable LRMs, an increasing DRR was an independent predictor of locally-advanced disease (OR = 3.91; 95% CI: 1.282–11.916; p = 0.017). Similarly, an increasing NLR was independently related to presence of locally-advanced disease (OR = 1.28; 95% CI: 1.027–1.591; p = 0.028). In univariate LRMs, patients with DRR > 1.21 had a higher risk of locally advanced disease (OR = 2.83; 95% CI: 1.312–6.128; p = 0.008). Similarly, in patients with NLR > 3.47 there was an increased risk of locally advanced disease (OR = 3.02; 95% CI: 1.374–6.651; p = 0.006). In multivariable LRMs, a DRR > 1.21 was an independent predictor of locally advanced disease (OR = 2.66; 95% CI: 1.12–6.35; p = 0.027). Similarly, an NLR > 3.47 was independently related to presence of locally advanced disease (OR = 2.24; 95% CI: 0.95–5.25; p = 0.065). No other covariates such as gender, BMI, neoadjuvant chemotherapy or diabetes reached statistical significance. The AUC of the multivariate LRM to assess the risk of locally advanced disease was 0.707 (95% CI: 0.623–0.795). Limitations include the retrospective nature of the study and the relatively small sample size.

Radical Cystectomy and Adjuvant Chemotherapy for Bladder Cancer in the Elderly: A Population-based Study

Urology ◽  
2015 ◽  
Vol 85 (4) ◽  
pp. 791-798 ◽  
Author(s):  
Michael J. Leveridge ◽  
D. Robert Siemens ◽  
William J. Mackillop ◽  
Yingwei Peng ◽  
Ian F. Tannock ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Adjuvant Chemotherapy ◽  
Radical Cystectomy ◽  
The Elderly ◽  
Population Based ◽  
Population Based Study
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