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Neoadjuvant chemotherapy bladder cancer

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https://www.readbyqxmd.com/read/28545841/oncologic-outcomes-for-patients-with-residual-cancer-at-cystectomy-following-neoadjuvant-chemotherapy-a-pathologic-stage-matched-analysis
#1
Bimal Bhindi, Igor Frank, Ross J Mason, Robert F Tarrell, Prabin Thapa, John C Cheville, Brian A Costello, Lance C Pagliaro, R Jeffrey Karnes, R Houston Thompson, Matthew K Tollefson, Stephen A Boorjian
While it has been demonstrated that receipt of neoadjuvant chemotherapy (NAC) before radical cystectomy (RC) improves survival compared to RC alone, the driving factor for this benefit may be from patients with ypT0 status at surgery. Meanwhile, the implications of having residual urothelial carcinoma of the bladder (rUCB) at RC after NAC are less clear. We therefore evaluated whether survival differed between patients with rUCB at RC after NAC and stage-matched controls who underwent RC alone. Patients who underwent NAC + RC (n = 180) were matched to controls who underwent RC alone (n=324) on the basis of pT and pN stage, margin status, and year of RC...
May 22, 2017: European Urology
https://www.readbyqxmd.com/read/28500617/post-chemotherapy-pd-l1-expression-correlates-with-clinical-outcomes-in-japanese-bladder-cancer-patients-treated-with-total-cystectomy
#2
Daisuke Noro, Shingo Hatakeyama, Takahiro Yoneyama, Yasuhiro Hashimoto, Takuya Koie, Toshiaki Kawaguchi, Chikara Ohyama
Programmed cell death ligand-1 (PD-L1) is a key target molecule of immunotherapy that is frequently overexpressed in bladder cancer. In the present study, we examined whether PD-L1 expression is associated with clinical outcomes in bladder cancer patients. We enrolled 102 bladder cancer patients treated with cystectomy at the Aomori Prefectural Hospital between April 2004 and May 2014. We conducted an immunohistochemical examination of PD-L1 expression using the SP142 assay. PD-L1 expression was scored at three diagnostic levels (0/1/2)...
June 2017: Medical Oncology
https://www.readbyqxmd.com/read/28481707/immune-checkpoint-blockade-in-metastatic-urothelial-cancer
#3
Arjun Vasant Balar
The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors' suggested management approaches. The goal of this series is to help readers better understand how to apply the results of key studies, including those published in Journal of Clinical Oncology, to patients seen in their own clinical practice...
May 8, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28469299/systemic-therapy-in-bladder-cancer
#4
REVIEW
Ian G Pinto
Systemic chemotherapy is essential for the management of muscle-invasive bladder cancer (MIBC) and metastatic bladder cancer (BCa). Neoadjuvant chemotherapy is key to the management of MIBC with many cisplatin-based regimens. Adjuvant chemotherapy may be considered for selected patients who did not receive neoadjuvant therapy. Systemic chemotherapy with radiotherapy is a critical component of a trimodal bladder-preserving approach and is superior to radiotherapy alone. Cisplatin-based chemotherapy has been the mainstay for metastatic BCa...
April 2017: Indian Journal of Urology: IJU: Journal of the Urological Society of India
https://www.readbyqxmd.com/read/28469298/where-are-we-with-bladder-preservation-for-muscle-invasive-bladder-cancer-in-2017
#5
REVIEW
Woodson Wade Smelser, Marcus A Austenfeld, Jeffrey Maxwell Holzbeierlein, Eugene Kang Lee
INTRODUCTION: In 2017, neoadjuvant, cisplatin-based chemotherapy followed by radical cystectomy (RC) is considered the gold standard therapy for muscle-invasive bladder based on randomized controlled trials. Across all tumor stages, this approach has been associated with the highest rates of disease-specific survival. However, RC is one of the most challenging procedures performed by urologic surgeons and carries with it significant risks of complications, hospital readmission, and even a small risk of mortality, in addition to lifestyle changes that can have long-term effects on well-being...
April 2017: Indian Journal of Urology: IJU: Journal of the Urological Society of India
https://www.readbyqxmd.com/read/28460994/erectile-dysfunction-treatment-following-radical-cystoprostatectomy-analysis-of-a-nationwide-insurance-claims-database
#6
Meera R Chappidi, Max Kates, Nikolai A Sopko, Gregory A Joice, Jeffrey J Tosoian, Phillip M Pierorazio, Trinity J Bivalacqua
INTRODUCTION: To improve care for patients after radical cystoprostatectomy (RCP), focus on survivorship issues such as sexual function needs to increase. Previous studies have demonstrated the burden of erectile dysfunction (ED) after RCP to be as high as 89%. AIM: To determine the rates of ED treatment use (phosphodiesterase type 5 inhibitors, injectable therapies, urethral suppositories, vacuum erection devices, and penile prosthetics) in patients with bladder cancer before and after RCP to better understand current patterns of care...
April 28, 2017: Journal of Sexual Medicine
https://www.readbyqxmd.com/read/28453896/clinical-and-patient-reported-outcomes-of-spare-a-randomised-feasibility-study-of-selective-bladder-preservation-versus-radical-cystectomy
#7
R A Huddart, A Birtle, L Maynard, M Beresford, J Blazeby, J Donovan, J D Kelly, T Kirkbank, D B McLaren, G Mead, C Moynihan, R Persad, C Scrase, R Lewis, E Hall
OBJECTIVES: To test the feasibility of a randomised trial in muscle invasive bladder cancer (MIBC) and compare outcomes in patients who receive neoadjuvant chemotherapy followed by radical cystectomy or selective bladder preservation, where definitive treatment (cystectomy or radiotherapy) is determined by response to chemotherapy. PATIENTS AND METHODS: SPARE is a multicentre randomised controlled trial comparing radical cystectomy and selective bladder preservation in patients with MIBC staged T2-3 N0 M0, fit for both treatment strategies and receiving three cycles of neoadjuvant chemotherapy...
April 28, 2017: BJU International
https://www.readbyqxmd.com/read/28447581/effect-of-cisplatin-based-neoadjuvant-chemotherapy-on-survival-in-patients-with-bladder-cancer-a-meta-analysis
#8
Gang Li, Hui-Min Niu, Hong-Tao Wu, Bao-Yu Lei, Xiao-Hua Wang, Xiao-Bo Guo, Shu-Lin Feng
PURPOSE: Cisplatin-based neoadjuvant chemotherapy (NAC) has been shown to improve survival in patients with muscle-invasive bladder cancer (MIBC) who underwent radical cystectomy as compared with patients who underwent surgery alone. It has also been suggested as current standard of care in surgically-fit patients with MIBC. This meta-analysis assessed the effect of cisplatin-based NAC on survival in patients with bladder cancer. SOURCE: PubMed, CENTRAL, and Embase were searched until November 22, 2016...
April 26, 2017: Clinical and Investigative Medicine. Médecine Clinique et Experimentale
https://www.readbyqxmd.com/read/28433377/neoadjuvant-chemotherapy-in-muscle-invasive-bladder-cancer-are-things-now-getting-personal
#9
EDITORIAL
Matthew D Galsky, John P Sfakianos, Bart S Ferket
No abstract text is available yet for this article.
April 19, 2017: European Urology
https://www.readbyqxmd.com/read/28410909/neoadjuvant-chemotherapy-in-elderly-patients-with-bladder-cancer-oncologic-outcomes-from-a-single-institution-experience
#10
Andrew R Leone, Kamran Zargar-Shoshtari, Gregory J Diorio, Pranav Sharma, David Boulware, Scott M Gilbert, Julio M Powsang, Jingsong Zhang, Wade J Sexton, Philippe E Spiess, Michael A Poch
INTRODUCTION: We conducted this study to determine if, in appropriately selected elderly patients receiving neoadjuvant chemotherapy (NAC), clinical outcomes including pathologic complete response/downstaging and overall survival were similar to a younger cohort. METHODS: Chart review was performed on patients receiving NAC for urothelial carcinoma of the bladder (UCB) from 2004 to 2013. A total of 116 patients were identified that underwent NAC from 2004 to 2013 for ≥ cT2N0M0 UCB...
February 1, 2017: Clinical Genitourinary Cancer
https://www.readbyqxmd.com/read/28408175/an-oncofetal-glycosaminoglycan-modification-provides-therapeutic-access-to-cisplatin-resistant-bladder-cancer
#11
Roland Seiler, Htoo Zarni Oo, Davide Tortora, Thomas M Clausen, Chris K Wang, Gunjan Kumar, Marina Ayres Pereira, Maj S Ørum-Madsen, Mette Ø Agerbæk, Tobias Gustavsson, Mie A Nordmaj, Jamie R Rich, Nada Lallous, Ladan Fazli, Sherry S Lee, James Douglas, Tilman Todenhöfer, Shaghayegh Esfandnia, Dulguun Battsogt, John S Babcook, Nader Al-Nakouzi, Simon J Crabb, Igor Moskalev, Bernhard Kiss, Elai Davicioni, George N Thalmann, Paul S Rennie, Peter C Black, Ali Salanti, Mads Daugaard
BACKGROUND: Although cisplatin-based neoadjuvant chemotherapy (NAC) improves survival of unselected patients with muscle-invasive bladder cancer (MIBC), only a minority responds to therapy and chemoresistance remains a major challenge in this disease setting. OBJECTIVE: To investigate the clinical significance of oncofetal chondroitin sulfate (ofCS) glycosaminoglycan chains in cisplatin-resistant MIBC and to evaluate these as targets for second-line therapy. DESIGN, SETTING, AND PARTICIPANTS: An ofCS-binding recombinant VAR2CSA protein derived from the malaria parasite Plasmodium falciparum (rVAR2) was used as an in situ, in vitro, and in vivo ofCS-targeting reagent in cisplatin-resistant MIBC...
April 10, 2017: European Urology
https://www.readbyqxmd.com/read/28399521/neoadjuvant-chemotherapy-with-gemcitabine-plus-cisplatin-in-patients-with-locally-advanced-bladder-cancer
#12
Dora Niedersüss-Beke, Thomas Puntus, Thomas Kunit, Birgit Grünberger, Michael Lamche, Wolfgang Loidl, Reinhard Böhm, Nicole Kraischits, Stefan Kudlacek, Paul Schramek, Johannes G Meran
BACKGROUND: Neoadjuvant chemotherapy with methotrexate-vinblastine-doxorubicin-cisplatin (MVAC) is the standard of care for muscle-invasive urothelial bladder cancer. Gemcitabine plus cisplatin (GC) shows similar efficacy with less toxicity in the metastatic setting and has therefore often been used interchangeably with MVAC. We report on the efficacy and safety of neoadjuvant GC in patients with locally advanced urothelial cancer. MATERIALS AND METHODS: We prospectively evaluated 87 patients in 2 centers...
April 12, 2017: Oncology
https://www.readbyqxmd.com/read/28390739/impact-of-molecular-subtypes-in-muscle-invasive-bladder-cancer-on-predicting-response-and-survival-after-neoadjuvant-chemotherapy
#13
Roland Seiler, Hussam Al Deen Ashab, Nicholas Erho, Bas W G van Rhijn, Brian Winters, James Douglas, Kim E Van Kessel, Elisabeth E Fransen van de Putte, Matthew Sommerlad, Natalie Q Wang, Voleak Choeurng, Ewan A Gibb, Beatrix Palmer-Aronsten, Lucia L Lam, Christine Buerki, Elai Davicioni, Gottfrid Sjödahl, Jordan Kardos, Katherine A Hoadley, Seth P Lerner, David J McConkey, Woonyoung Choi, William Y Kim, Bernhard Kiss, George N Thalmann, Tilman Todenhöfer, Simon J Crabb, Scott North, Ellen C Zwarthoff, Joost L Boormans, Jonathan Wright, Marc Dall'Era, Michiel S van der Heijden, Peter C Black
BACKGROUND: An early report on the molecular subtyping of muscle-invasive bladder cancer (MIBC) by gene expression suggested that response to neoadjuvant chemotherapy (NAC) varies by subtype. OBJECTIVE: To investigate the ability of molecular subtypes to predict pathological downstaging and survival after NAC. DESIGN, SETTING, AND PARTICIPANTS: Whole transcriptome profiling was performed on pre-NAC transurethral resection specimens from 343 patients with MIBC...
April 5, 2017: European Urology
https://www.readbyqxmd.com/read/28319171/a-reported-20-gene-expression-signature-to-predict-lymph-node-positive-disease-at-radical-cystectomy-for-muscle-invasive-bladder-cancer-is-clinically-not-applicable
#14
Kim E M van Kessel, Harmen J G van de Werken, Irene Lurkin, Angelique C J Ziel-van der Made, Ellen C Zwarthoff, Joost L Boormans
BACKGROUND: Neoadjuvant chemotherapy (NAC) for muscle-invasive bladder cancer (MIBC) provides a small but significant survival benefit. Nevertheless, controversies on applying NAC remain because the limited benefit must be weight against chemotherapy-related toxicity and the delay of definitive local treatment. Therefore, there is a clear clinical need for tools to guide treatment decisions on NAC in MIBC. Here, we aimed to validate a previously reported 20-gene expression signature that predicted lymph node-positive disease at radical cystectomy in clinically node-negative MIBC patients, which would be a justification for upfront chemotherapy...
2017: PloS One
https://www.readbyqxmd.com/read/28290459/contemporary-update-on-neoadjuvant-therapy-for-bladder-cancer
#15
REVIEW
Daniel P Nguyen, George N Thalmann
Administration of neoadjuvant chemotherapy preceding radical cystectomy in patients with bladder cancer remains a matter of debate. Results of prospective, randomized studies have demonstrated an overall absolute survival benefit of 5% at 5 years, provided cisplatin-based combination regimens are used. Owing to the perception of a modest survival benefit, the medical community has been slow to adopt the use of neoadjuvant chemotherapy. Other reasons for the underuse of neoadjuvant chemotherapy range from patient ineligibility to fear of delaying potentially curative surgery in nonresponders...
March 14, 2017: Nature Reviews. Urology
https://www.readbyqxmd.com/read/28274590/role-of-inflammation-in-the-perioperative-management-of-urothelial-bladder-cancer-with-squamous-cell-features-impact-of-neutrophil-to-lymphocyte-ratio-on-outcomes-and-response-to-neoadjuvant-chemotherapy
#16
Oscar Buisan, Anna Orsola, Mario Oliveira, Roberto Martinez, Olatz Etxaniz, Joan Areal, Luis Ibarz
BACKGROUND: Neutrophil-to-lymphocyte ratio (NLR) might reflect an increased neutrophilic inflammatory response, and urothelial tumors with squamous-cell features (SqD) have been linked to inflammation. We hypothesized that NLR could be prognostic in these patients. PATIENTS AND METHODS: In patients with SqD muscle-invasive bladder cancer treated with curative intent, NLR and relationships with outcomes were analyzed by Cox regression, log-rank, and Kaplan-Meier analysis...
February 6, 2017: Clinical Genitourinary Cancer
https://www.readbyqxmd.com/read/28272009/neoadjuvant-chemotherapy-a-new-standard-for-muscle-invasive-bladder-cancer
#17
Nabil Ismaili
Bladder cancer is the seventh most common cancer and the ninth most common cause of cancer deaths for men worldwide. Cystectomy with pelvic lymph nodes dissection is the standard local treatment of muscle invasive bladder cancer (MIBC) (T2-T4). In the last decade, the management of MIBC had become multidisciplinary involving peri-operative chemotherapy (neo- or adjuvant chemotherapy). Randomized trials and meta-analyses confirmed the survival benefit of neoadjuvant chemotherapy before local treatment (surgery and/or radiotherapy)...
January 2017: Gulf Journal of Oncology
https://www.readbyqxmd.com/read/28244408/tolerability-of-concurrent-chemoradiation-therapy-with-gemcitabine-gemx-with-and-without-prior-neoadjuvant-chemotherapy-in-muscle-invasive-bladder-cancer
#18
Catherine Thompson, Nuradh Joseph, Benjamin Sanderson, John Logue, James Wylie, Tony Elliott, Jeanette Lyons, Carmel Anandadas, Ananya Choudhury
PURPOSE: The aim of this study is to assess the tolerability of concurrent chemoradiation therapy with gemcitabine (GemX) in muscle invasive bladder cancer following neoadjuvant chemotherapy (neoGemX) by use of patient- and provider-reported outcomes. METHODS AND MATERIALS: Seventy-eight patients were treated with GemX. Thirty-eight received prior neoadjuvant chemotherapy (NAC). Patients were prospectively assessed during treatment and at 6 weeks and 12 months after treatment completion...
March 15, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28214574/minimally-invasive-versus-open-approach-for-cystectomy-trends-in-the-utilization-and-demographic-or-clinical-predictors-using-the-national-cancer-database
#19
Andrew G Bachman, Alexander A Parker, Marshall D Shaw, Brian W Cross, Kelly L Stratton, Michael S Cookson, Sanjay G Patel
OBJECTIVE: To examine temporal national trends of operative approach for cystectomy and identify demographic or clinical predictive factors that influence choice of approach. METHODS: We performed a retrospective cohort study of patients who underwent cystectomy for bladder cancer between 2010 and 2013 using the National Cancer Database. Approach was stratified by open vs minimally invasive (robotic or laparoscopic). Univariate Pearson chi-square and multivariate logistic regression analysis were used to assess the relationships between demographic and hospital factors and the receipt of minimally invasive or open surgical approach...
February 15, 2017: Urology
https://www.readbyqxmd.com/read/28187218/reduced-expression-of-argininosuccinate-synthetase-1-has-a-negative-prognostic-impact-in-patients-with-pancreatic-ductal-adenocarcinoma
#20
Qingqing Liu, John Stewart, Hua Wang, Asif Rashid, Jun Zhao, Matthew H Katz, Jeffrey E Lee, Jason B Fleming, Anirban Maitra, Robert A Wolff, Gauri R Varadhachary, Sunil Krishnan, Huamin Wang
Argininosuccinate synthetase 1 (ASS1), the rate-limiting enzyme for arginine biosynthesis, is expressed in many types of human malignancies. Recent studies showed that ASS1 may have tumor suppressor function and that ASS1 deficiency is associated with clinical aggressiveness in nasopharyngeal carcinoma, myxofibrosarcomas and bladder cancer. The goal of this study was to evaluate the prognostic impact of ASS1 expression in patients with pancreatic ductal adenocarcinoma (PDAC). Our study included two independent cohorts: untreated cohort, which was comprised of 135 patients with PDAC who underwent pancreatoduodenectomy (PD) without pre-operative neoadjuvant therapy, and treated cohort, which was comprised of 122 patients with PDAC who have completed neoadjuvant therapy and PD...
2017: PloS One
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