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Pal SK , Milowsky MI , Plimack ER
Optimizing systemic therapy for bladder cancer
J Natl Compr Canc Netw. 2013 Jul 1;11(7) :793-804
PMID: 23847217   
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Over the past several decades, few new systemic agents have been incorporated into the treatment paradigm for bladder cancer. Platinum-based therapy remains the cornerstone of treatment in the perioperative and metastatic settings. Despite level one evidence, use of cisplatin-based therapy in the neoadjuvant setting has been dismal. Second-line therapy for metastatic disease has only modest activity with no survival benefit. However, the elucidation and investigation of novel molecular targets, new therapeutics, and associated biomarkers with strong biologic rationale are actively changing the landscape in bladder cancer. Although the field is moving rapidly, no new drug approvals are currently pending and a need remains to continue to educate the medical oncology and urology communities on the optimal use of currently available treatments. This article outlines the evidence, including that from prospective studies and meta-analyses, providing the basis for the current recommendations from NCCN, and details previous and ongoing studies of targeted therapy for bladder cancer.
Pal, Sumanta K Milowsky, Matthew I Plimack, Elizabeth R United States Journal of the National Comprehensive Cancer Network : JNCCN J Natl Compr Canc Netw. 2013 Jul 1;11(7):793-804.