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Update on perioperative systemic therapy for urothelial carcinoma
Clin Adv Hematol Oncol. 2019 Mar;17(3) :176-183
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Level 1 evidence supports cisplatin-based neoadjuvant chemotherapy (NAC) in muscle-invasive urothelial bladder cancer (MIUBC). Recent data from small prospective trials with neoadjuvant immune checkpoint inhibitors are encouraging, but long-term follow-up is required. Randomized trials have failed to accrue a sufficient number of patients and have not demonstrated a survival benefit with adjuvant chemotherapy in MIUBC, but for those with high-risk features at surgery, adjuvant cisplatin-based therapy is appropriate. In upper tract urothelial carcinoma, several retrospective trials and one recent phase 2 prospective trial support the use of NAC, and a randomized trial with adjuvant chemotherapy demonstrated improved disease- and metastasis-free survival and a trend toward improved overall survival.
Rouvinov, Keren Plimack, Elizabeth R Zibelman, Matthew Ghatalia, Pooja Geynisman, Daniel M Journal Article Review United States Clin Adv Hematol Oncol. 2019 Mar;17(3):176-183.