Neoadjuvant and adjuvant therapy for muscle-invasive bladder cancer Book Section
| Authors: | Guercio, B. J.; Iyer, G. |
| Editors: | Stratton, K. L.; Morgans, A. K. |
| Article/Chapter Title: | Neoadjuvant and adjuvant therapy for muscle-invasive bladder cancer |
| Abstract: | Muscle-invasive bladder cancer (MIBC) is frequently a systemic disease at diagnosis due to clinically occult micrometastases. Neoadjuvant cisplatin-based chemotherapy prior to surgical resection to address occult disseminated disease reduces risk of recurrence and is the current standard of care for MIBC, supported by level I evidence. While adjuvant chemotherapy could theoretically offer similar benefit, postoperative cisplatin-based chemotherapy is more challenging to implement in clinical practice, and trials have failed to demonstrate a consistent benefit for adjuvant chemotherapy. Notably, many patients with MIBC are not eligible for cisplatin-based therapy due to comorbidities, and currently these patients proceed to definitive local therapy. Following the advent of immunotherapy for metastatic disease, numerous trials are actively exploring checkpoint blockade and other novel agents in the perioperative space. Herein, we highlight the seminal investigations of perioperative systemic treatment of MIBC as well as investigational biomarkers that may help identify patients who are most likely to benefit from these therapies. We also review novel perioperative regimens currently under investigation, including combinations of immune checkpoint blockade with chemotherapy and/or targeted agents. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022. |
| Keywords: | immunotherapy; perioperative chemotherapy; neoadjuvant; adjuvant; muscle-invasive bladder cancer; muscle-invasive urothelial carcinoma; localized bladder cancer |
| Book Title: | Urologic Oncology: Multidisciplinary Care for Patients |
| ISBN: | 978-3-030-89890-8 |
| Publisher: | Springer |
| Publication Place: | Cham, Switzerland |
| Date Published: | 2022-01-01 |
| Start Page: | 349 |
| End Page: | 379 |
| Language: | English |
| DOI: | 10.1007/978-3-030-89891-5_17 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Book Chapter: 17 -- Source: Scopus |
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