[Modern chemotherapy of invasive bladder cancer]

Abstract

Purpose: to identify the place and role of modern chemotherapy in invasive bladder cancer.

Methods: overview of the important data of papers presented in the last three years.

Results: Cisplatin-based chemotherapy with methotrexate-vinblastine-doxorubicin-cisplatin (M-VAC) or gemcitabine-cisplatin (GC) is the standard treatment and prolongs survival in metastatic disease. The paclitaxel-gemcitabine-cisplatin (TGC) protocol did not change standard therapy. Neoadjuvant chemotherapy before cystectomy for T2-3 disease provides a survival benefit compared with surgery alone. Adjuvant chemotherapy is less compelling, however, it is used in case of locally advanced, extravesical and/or lymph node-positive disease. The identification of patient's risk factors helps the decision of individual treatment strategy.

Conclusion: Better understanding of molecular mechanisms and carcinogenetic pathways of bladder cancer and combination of old and new drugs with targeted therapy may increase the effectiveness of treatment in bladder cancer.