• Expert Opin Pharmacother · Aug 2008

    Review

    Neoadjuvant chemotherapy preceding cystectomy for bladder cancer.

    • Guru Sonpavde, Gilad E Amiel, Martha P Mims, Teresa G Hayes, and Seth P Lerner.
    • Texas Oncology, P.A. and US Oncology Research, 501 Medical Center Blvd, Webster, TX 77598, USA. gurUSonpavde@usoncology.com
    • Expert Opin Pharmacother. 2008 Aug 1; 9 (11): 1885-93.

    BackgroundOccult micrometastasis at the time of radical cystectomy leads predominantly to distant failures in patients with locally advanced, muscle-invasive transitional cell carcinoma of the bladder.ObjectivesData supporting neoadjuvant chemotherapy for locally advanced bladder cancer are reviewed.ResultsStudies evaluating adjuvant chemotherapy have been limited by inadequate statistical power. However, randomized clinical trials have demonstrated a survival benefit for neoadjvuant cisplatin-based combination chemotherapy. Trials employing neoadjuvant therapy are particularly valuable in the development of novel systemic therapy regimens, since pathological complete remission appears to be a powerful prognostic factor for long-term survival.ConclusionNeoadjuvant chemotherapy is a standard for the therapy of locally advanced bladder cancer, and the neoadjuvant paradigm may assist in accelerating novel agent development.

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