Current and Future Landscape of Perioperative Treatment for Muscle-Invasive Bladder Cancer
- PMID: 36765525
- PMCID: PMC9913718
- DOI: 10.3390/cancers15030566
Current and Future Landscape of Perioperative Treatment for Muscle-Invasive Bladder Cancer
Abstract
Cisplatin-based neoadjuvant chemotherapy followed by radical cystectomy is the current standard of care for muscle-invasive bladder cancer (MIBC). However, less than half of patients are candidates for this treatment, and 50% will develop metastatic disease. Adjuvant chemotherapy could be offered if neoadjuvant treatment has not been administered for suitable patients. It is important to reduce the risk of systemic recurrence and improve the prognosis of localized MIBC. Systemic therapy for metastatic urothelial carcinoma has evolved in recent years. Immune checkpoint inhibitors and targeted agents, such as antibody-drug conjugates or FGFR inhibitors, are new therapeutic alternatives and have shown their benefit in advanced disease. Currently, several clinical trials are investigating the role of these drugs, as monotherapy and in combination with chemotherapy, in the neoadjuvant and adjuvant settings with promising outcomes. In addition, the development of predictive biomarkers could predict responses to neoadjuvant therapies.
Keywords: adjuvant; chemotherapy; immunotherapy; muscle-invasive bladder cancer; neoadjuvant; targeted agents.
Conflict of interest statement
PG received travel and educational support from Pfizer, Merck Serono, Ipsen, Sanofi-Genzyne, Roche and Jansen and has served as advisor and delivered lectures for BMS, MSD, Merck Serono, Pfizer, Ipsen, Roche, Adacap, Eisai, Sanofi-Genzyme, Novartis, Astellas and Jansen. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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