scholarly journals Neoadjuvant chemotherapy (NC) should be administered to fit patients with newly diagnosed, potentially resectable muscle-invasive urothelial cancer (MIUC) of the bladder – A 2013 CAGMO Consensus Statement and Call for a Streamlined Referral Process

2013 ◽  
Vol 7 (9-10) ◽  
pp. 312 ◽  
Author(s):  
Jo-An Seah ◽  
Srikala Sridhar ◽  
Lori Wood ◽  
Normand Blais ◽  
Scott North ◽  
...  
Keyword(s):  
Neoadjuvant Chemotherapy ◽  
Patient Outcomes ◽  
Urothelial Cancer ◽  
Consensus Statement ◽  
Urologic Oncology ◽  
Canadian Association ◽  
Medical Oncologists ◽  
Cancer Of The Bladder ◽  
Muscle Invasive ◽  
Improve Patient

Neoadjuvant chemotherapy (NC) improves overall survival inpatients with resectable muscle-invasive urothelial cancer of the bladder (MIBC). However uptake of NC in Canada is disappointingly low. Following a detailed literature review and in consultation with urologic oncology, the Canadian Association of Genitourinary Medical Oncologists (CAGMO) has developed a consensus statement for the use of NC in MIBC. Our primary goal is to increase the uptake of NC for MIBC in Canada and improve patient outcomes.

scholarly journals Treatment of muscle-invasive bladder cancer in Canada: A survey of genitourinary medical oncologists and urologists

2014 ◽  
Vol 8 (9-10) ◽  
pp. 309 ◽  
Author(s):  
Tina Hsu ◽  
Peter C Black ◽  
Kim N Chi ◽  
Christina M Canil ◽  
Bernie J Eigl ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Renal Function ◽  
Performance Status ◽  
Standard Of Care ◽  
Invasive Bladder Cancer ◽  
Muscle Invasive Bladder Cancer ◽  
Urologic Oncology ◽  
Canadian Association ◽  
Medical Oncologists ◽  
Muscle Invasive

Introduction: Uptake of neoadjuvant chemotherapy (NC) for muscle-invasive bladder cancer (MIBC) has been low despite evidence of a survival benefit. The primary aim of this study was to better understand why the rates are low and determine what factors specifically influence the decision to recommend NC for MIBC.Methods: A 31-question survey was emailed between 2009 and 2011 to medical oncologists belonging to the Canadian Association of Genitourinary Medical Oncologists (CAGMO); and to urologists belonging to the Canadian Urologic Oncology Group (CUOG). We gathered data on practice characteristics, referrals for NC, factors influencing NC use, and chemotherapy regimens offered. Responses were summarized using descriptive statistics.Results: In total, 26/30 (87%) medical oncologists and 25/84 (30%) urologists, who were primarily academic, completed the survey. Most clinicians (medical oncologists 96%, urologists 88%) recommended NC for MIBC, because they considered it to be the standard of care, but most medical oncologists saw ≤6 referrals annually. Performance status, presence of comorbidities and renal function were key considerations in offering NC. NC was not offered if performance status ≥2 (medical oncologists 38%, urologists 44%), age >80 (medical oncologists 46%, urologists 39%), or glomerular filtration rate ≤40 mL/min (medical oncologists 81%, urologists 50%).Conclusions: Most academic clinicians in Canada believe that cisplatin-based combination NC is the standard of care for MIBC and recommend it for patients with adequate performance status and renal function. Using a multidisciplinary approach to treat this disease may be one strategy to increase referral rates for NC and uptake of NC.

scholarly journals Neoadjuvant Chemotherapy Use in Bladder Cancer: A Survey of Current Practice and Opinions

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
N. G. Cowan ◽  
Y. Chen ◽  
T. M. Downs ◽  
B. H. Bochner ◽  
A. B. Apolo ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Univariate Analysis ◽  
Utilization Rate ◽  
Urologic Oncology ◽  
Medical Oncologists ◽  
Level 1 ◽  
Muscle Invasive ◽  
Question Survey ◽  
Descriptive Statistical Analysis

Objectives. Level 1 evidence supports the use of neoadjuvant chemotherapy (NAC) to improve overall survival in muscle invasive bladder cancer; however utilization rates remain low. The aims of our study were to determine factors associated with NAC use, to more clearly define reasons for low utilization, and to determine the current rate of NAC use among urologic oncologists.Materials and Methods. Active members of the Society for Urologic Oncology were provided a 20-question survey. Descriptive statistical analysis was conducted for each question and univariate analysis was performed.Results. We achieved a response rate of 21%. Clinical T3/T4 disease was the most often selected reason for recommending NAC (87%). Concerns with recommending NAC were age and comorbidities (54%) followed by delay in surgery (35%). An association was identified between urologic oncologists who discussed NAC with >90% of their patients and medical oncologists “always” recommending NAC (P=0.0009). NAC utilization rate was between 30 and 57%.Conclusions. Amongst this highly specialized group of respondents, clinical T3-T4 disease was the most common reason for implementation of NAC. Respondents who frequently discussed NAC were more likely to report their medical oncologist always recommending NAC. Reported NAC use was higher in this surveyed group (30–57%) compared with recently published rates.

scholarly journals Management of carcinoma of the penis: Consensus statement from the Canadian Association of Genitourinary Medical Oncologists (CAGMO)

2013 ◽  
Vol 7 (11-12) ◽  
pp. 797 ◽  
Author(s):  
Suzanne Richter ◽  
J. Dean Ruether ◽  
Lori Wood ◽  
Christina Canil ◽  
Patricia Moretto ◽  
...  
Keyword(s):  
Consensus Statement ◽  
Canadian Association ◽  
Medical Oncologists

scholarly journals Treatment options for muscle-invasive urothelial cancer for patients who were not eligible for cystectomy or neoadjuvant chemotherapy with methotrexate, vinblastine, doxorubicin, and cisplatin

Cancer ◽  
2008 ◽  
Vol 112 (10) ◽  
pp. 2181-2187 ◽  
Author(s):  
Celestia S. Higano ◽  
Catherine M. Tangen ◽  
Wael A. Sakr ◽  
James Faulkner ◽  
Saul E. Rivkin ◽  
...  
Keyword(s):  
Neoadjuvant Chemotherapy ◽  
Urothelial Cancer ◽  
Treatment Options ◽  
Muscle Invasive

Neoadjuvant or adjuvant immunotherapy in bladder cancer: biological opportunity or clinical utility?

2021 ◽  
pp. 030089162110616
Author(s):  
Fausto Petrelli ◽  
Gianluca Perego ◽  
Ivano Vavassori ◽  
Andrea Luciani
Keyword(s):  
Bladder Cancer ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitors ◽  
Urothelial Cancer ◽  
Checkpoint Inhibitors ◽  
Phase Iii ◽  
Invasive Bladder Cancer ◽  
Muscle Invasive Bladder Cancer ◽  
Cancer Of The Bladder ◽  
Muscle Invasive

In urothelial cancer of the bladder, the introduction of immunotherapy with immune checkpoint inhibitors represents progress in the management of the disease’s early and advanced stages. In particular, recent studies have implemented these drugs in the neoadjuvant and adjuvant phases to treat muscle-invasive bladder cancer. In some studies, patients received neoadjuvant immune checkpoint inhibitors alone (PURE and ABACUS) to treat muscle invasive bladder cancer, whereas other studies provided this therapy to cisplatin-ineligible patients. Furthermore, a large Phase III study (CheckMate 247) compared placebo with adjuvant nivolumab therapy in patients with high-risk urothelial cancer after neoadjuvant chemotherapy and surgery or surgery alone. Despite some uncertain niches (nonbladder, PD-L1-negative tumors, and node-negative resected cancers), certain biological opportunities (exploring new targets, evaluating in vivo pathologic response, focusing on biomarkers for response) and clinical uses (avoiding chemotherapy at all or in frail patients, attaining similar pathologic complete response rates as in cisplatin-based chemotherapy) are valid reasons for incorporating these agents into the therapeutic armamentarium of medical uro-oncologists.

Multidisciplinary management and use of neoadjuvant cisplatin combination chemotherapy in patients with muscle-invasive urothelial bladder cancer.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e15012-e15012
Author(s):  
Jean H. Hoffman-Censits ◽  
Jianqing Lin ◽  
Costas D. Lallas ◽  
Timothy Norman Showalter ◽  
Robert Benjamin Den ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Cancer Center ◽  
Chemotherapy Administration ◽  
Medical Oncologists ◽  
Urothelial Bladder ◽  
Historic Data ◽  
Muscle Invasive ◽  
Evidence Based Guidelines ◽  
Lost To Follow Up

e15012 Background: Although randomized data support neoadjuvant cisplatin-based chemotherapy prior to cystectomy for muscle invasive bladder cancer (MIBC), a recent retrospective study of 14 academic centers demonstrated only 12% of patients eligible for cystectomy received neoadjuvant chemotherapy. We reviewed utilization of neoadjuvant chemotherapy in a cohort of patients with MIBC seen at the Genitourinary Multidisciplinary Cancer Clinic (GUMDCC) of the Kimmel Cancer Center at Thomas Jefferson University (TJU). Methods: With IRB approval, records were reviewed for patients seen in the GUMDCC by urologists, radiation and medical oncologists with MIBC expertise from August 2009 to August 2011. Results: Of the201 patients with bladder or urothelial carcinoma, 46 (23%) with T2-T4 MIBC were identified and evaluated for neoadjuvant chemotherapy prior to radical cystectomy. 14 of 46 (30%) had renal, cardiac or other comorbidities rendering them unfit for cisplatin or cystectomy, and 2 were never referred to medical oncology. Of the 30 patients eligible for cisplatin and cystectomy, 2 were treated at outside institutions, 4 were recommended for treatment but were lost to follow up, and 4 who had refused neoadjuvant chemotherapy had adverse pathology at cystectomy and received adjuvant chemotherapy. Twenty eligible patients (66%) initiated neoadjuvant chemotherapy at TJU, 8 of those (40%) on clinical trial. 100% of patients treated with neoadjuvant chemotherapy at TJU received cisplatin based regimens, and 17 of 20 patients received at least 3 cycles. Chemotherapy was initiated in an average of 29.8 days of multidisciplinary evaluation. Conclusions: Multidisciplinary evaluation and management of patients with MIBC leads to improved compliance with evidence based guidelines and higher rates of cisplatin based neoadjuvant chemotherapy administration compared with historic data.

Adjuvant chemotherapy for residual disease after neoadjuvant chemotherapy for muscle invasive urothelial cancer (MIUC).

2015 ◽  
Vol 33 (15_suppl) ◽  
pp. 4524-4524 ◽  
Author(s):  
Lauren Christine Harshman ◽  
Lillian Werner ◽  
Yu-Ning Wong ◽  
Evan Y. Yu ◽  
Ajjai Shivaram Alva ◽  
...  
Keyword(s):  
Adjuvant Chemotherapy ◽  
Neoadjuvant Chemotherapy ◽  
Urothelial Cancer ◽  
Residual Disease ◽  
Muscle Invasive
Sign in / Sign up

Export Citation Format

Share Document