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Neoadjuvant chemotherapy bladder cancer

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https://www.readbyqxmd.com/read/29657089/mechanistic-target-of-rapamycin-mtor-protein-expression-in-the-tumor-and-its-microenvironment-correlates-with-more-aggressive-pathology-at-cystectomy
#1
Brian R Winters, Funda Vakar-Lopez, Lisha Brown, Bruce Montgomery, Roland Seiler, Peter C Black, Joost L Boormans, Marc Dall Era, Elai Davincioni, James Douglas, Ewan A Gibb, Bas W G van Rhijn, Michiel S van der Heijden, Andrew C Hsieh, Jonathan L Wright, Hung-Ming Lam
BACKGROUND: The mechanistic target of rapamycin (mTOR) has been implicated in driving tumor biology in multiple malignancies, including urothelial carcinoma (UC). We investigate how mTOR and phosphorylated mTOR (pmTOR) protein expression correlate with chemoresponsiveness in the tumor and its microenvironment at final pathologic staging after neoadjuvant chemotherapy (NAC). METHODS: A single-institution retrospective analysis was performed on 62 patients with cT2-4Nany UC undergoing NAC followed by radical cystectomy...
April 12, 2018: Urologic Oncology
https://www.readbyqxmd.com/read/29650143/perioperative-immunotherapy-in-muscle-invasive-bladder-cancer-and-upper-tract-urothelial-carcinoma
#2
REVIEW
Min Yuen Teo, Jonathan E Rosenberg
Neoadjuvant chemotherapy improves survival in patients with muscle-invasive bladder cancer. However, a significant proportion of patients are ineligible for cisplatin owing to renal impairment or other medical comorbidities. The introduction of anti-programmed cell death protein 1/programmed death-ligand 1(PD1/PD-L1) checkpoint inhibitors has redefined the therapeutic landscape for platinum-resistant urothelial cancers; their clinical efficacy and favorable toxicity render these agents attractive therapeutic options either as monotherapy or in combination with other agents in earlier disease states, including muscle-invasive disease...
May 2018: Urologic Clinics of North America
https://www.readbyqxmd.com/read/29650132/optimal-timing-of-chemotherapy-and-surgery-in-patients-with-muscle-invasive-bladder-cancer-and-upper-urinary-tract-urothelial-carcinoma
#3
REVIEW
William Tabayoyong, Roger Li, Jianjun Gao, Ashish Kamat
Radical cystectomy with bilateral pelvic lymph node dissection is the standard of care for patients with clinically localized muscle-invasive bladder cancer. Survival after radical cystectomy is associated with final pathologic staging. Survival decreases with increasing pT stage because of the presence of occult micrometastases, indicating the need for systemic chemotherapy. Systemic chemotherapy is delivered as either neoadjuvant therapy preoperatively, or as adjuvant therapy postoperatively. This article reviews the evidence for neoadjuvant and adjuvant chemotherapy for the treatment of muscle-invasive bladder and upper tract urothelial cancer and offers recommendations based on these data and recently updated clinical guidelines...
May 2018: Urologic Clinics of North America
https://www.readbyqxmd.com/read/29615077/spire-combining-sgi-110-with-cisplatin-and-gemcitabine-chemotherapy-for-solid-malignancies-including-bladder-cancer-study-protocol-for-a-phase-ib-randomised-iia-open-label-clinical-trial
#4
Simon Crabb, Sarah J Danson, James W F Catto, Cathy McDowell, James N Lowder, Joshua Caddy, Denise Dunkley, Jessica Rajaram, Deborah Ellis, Stephanie Hill, David Hathorn, Amy Whitehead, Mihalis Kalevras, Robert Huddart, Gareth Griffiths
BACKGROUND: Urothelial bladder cancer (UBC) accounts for 10,000 new diagnoses and 5000 deaths annually in the UK (Cancer Research UK, http://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/bladder-cancer , Cancer Research UK, Accessed 26 Mar 2018). Cisplatin-based chemotherapy is standard of care therapy for UBC for both palliative first-line treatment of advanced/metastatic disease and radical neoadjuvant treatment of localised muscle invasive bladder cancer...
April 3, 2018: Trials
https://www.readbyqxmd.com/read/29606341/myeloid-derived-suppressors-cells-mdsc-correlate-with-clinicopathologic-factors-and-pathologic-complete-response-pcr-in-patients-with-urothelial-carcinoma-uc-undergoing-cystectomy
#5
REVIEW
Moshe C Ornstein, Claudia Marcela Diaz-Montero, Patricia Rayman, Paul Elson, Samuel Haywood, James H Finke, Jin S Kim, Paul G Pavicic, Marcelo Lamenza, Sarah Devonshire, Priscilla Dann, Kim Schach, Andrew Stephenson, Steven Campbell, Hamid Emamekhoo, Marc S Ernstoff, Christopher J Hoimes, Timothy D Gilligan, Brian I Rini, Jorge A Garcia, Petros Grivas
BACKGROUND: Myeloid derived suppressor cells (MDSC) are heterogeneous immunosuppressive cells with potential predictive and prognostic roles in cancer. The association between MDSC, clinicopathologic factors, and pathologic response in patients with bladder urothelial carcinoma (UC) was explored. METHODS: Peripheral blood or tissue were collected from patients with UC undergoing definitive surgery. MDSCs levels were measured in peripheral blood mononuclear cells and fresh tumor tissue...
March 29, 2018: Urologic Oncology
https://www.readbyqxmd.com/read/29603871/modeling-cost-effectiveness-of-a-biomarker-based-approach-to-neoadjuvant-chemotherapy-for-muscle-invasive-bladder-cancer
#6
Yair Lotan, Solomon L Woldu, Oner Sanli, Peter Black, Matthew I Milowsky
OBJECTIVES: To model the cost-effectiveness (CE) of a biomarker-based approach to select patients for neoadjuvant chemotherapy (NAC) prior to radical cystectomy (RC) in muscle-invasive bladder cancer (MIBC). MATERIALS AND METHODS: We obtained most recently clinical studies on locally-advanced bladder cancer treated by RC, including stage distributions, overall survival (OS) estimates, associated costs, and utilization/response to NAC. Additionally, we estimated the putative efficacy of 3 biomarkers to select patients for NAC: DNA repair gene panel [ATM, RB1, and FANCC], ERCC2, and RNA subtypes...
March 31, 2018: BJU International
https://www.readbyqxmd.com/read/29602638/pattern-of-node-metastases-in-patients-treated-with-radical-cystectomy-and-extended-or-superextended-pelvic-lymph-node-dissection-due-to-bladder-cancer
#7
Marco Moschini, Emilio Arbelaez, Julian Cornelius, Agostino Mattei, Shahrokh F Shariat, Paolo Dell Oglio, Emanuele Zaffuto, Andrea Salonia, Francesco Montorsi, Alberto Briganti, Renzo Colombo, Andrea Gallina
BACKGROUND: Pelvic lymph node dissection (PLND) has a diagnostic and therapeutic role during radical cystectomy in bladder cancer patients. However, at the time, no prospective data supports the value of extended PLND in improving survival expectances. We sought to describe incidence and location of node metastases in patients treated with extended and superextended PLND. METHODS: We evaluated 653 contemporary patients with clinically nonmetastatic high risk nonmuscle invasive or muscle-invasive bladder cancer treated with radical cystectomy and extended or superextended PLND without neoadjuvant chemotherapy at a single tertiary referral center between 1990 and 2013...
March 27, 2018: Urologic Oncology
https://www.readbyqxmd.com/read/29599345/significance-of-perioperative-chemotherapy-in-squamous-cell-carcinoma-of-the-upper-and-lower-urinary-tract
#8
Tomoyuki Makino, Kouji Izumi, Ariunbold Natsagdorj, Hiroaki Iwamoto, Suguru Kadomoto, Renato Naito, Yoshifumi Kadono, Atsushi Mizokami
BACKGROUND/AIM: To evaluate the clinicopathological characteristics and prognosis of squamous cell carcinoma (SCC) of the urinary tract (UT) urothelium, and investigate the utility of perioperative chemotherapy. PATIENTS AND METHODS: Thirty-three patients diagnosed with SCC in renal pelvis, ureter and bladder at the Kanazawa University between 2007 and 2017 were included in this retrospective study. Cancer-specific survival (CSS) rates according to cancer stage and neoadjuvant chemotherapy (NAC) were determined...
April 2018: Anticancer Research
https://www.readbyqxmd.com/read/29576445/feasibility-of-cisplatin-based-neoadjuvant-chemotherapy-in-muscle-invasive-bladder-cancer-patients-with-diminished-renal-function
#9
Vadim S Koshkin, Pedro C Barata, Lisa A Rybicki, Haris Zahoor, Nima Almassi, Alicia M Redden, Amr F Fergany, Jihad Kaouk, Georges-Pascal Haber, Andrew J Stephenson, Moshe C Ornstein, Timothy Gilligan, Jorge A Garcia, Brian I Rini, Petros Grivas
BACKGROUND: Cisplatin-based neoadjuvant chemotherapy (NAC) before radical cystectomy is the standard of care in muscle-invasive bladder cancer. There are limited data regarding chemotherapy tolerability and outcomes for patients with low glomerular filtration rate (GFR) who receive cisplatin-based NAC. PATIENTS AND METHODS: A retrospective analysis of patients who received cisplatin-based NAC at Cleveland Clinic (2005-2016) was undertaken. Patients with pre-NAC GFR < 60 mL/min by either Cockcroft-Gault (CG) or Modification of Diet in Renal Disease (MDRD) formula were compared to patients with GFR ≥ 60 mL/min for NAC tolerability, pathologic complete and partial response (pPR), and the ability to undergo radical cystectomy...
February 22, 2018: Clinical Genitourinary Cancer
https://www.readbyqxmd.com/read/29576423/iatrogenic-pathology-of-the-urinary-bladder
#10
REVIEW
Antonio Lopez-Beltran, Rodolfo Montironi, Maria R Raspollini, Liang Cheng, George J Netto
Intravesical immunotherapy, chemotherapy, and neoadjuvant systemic chemotherapy are among the most frequent therapeutic procedures to treat malignancies of the urinary bladder. These treatment modalities produce reactive morphologic changes in the urothelium that can mimic urothelial carcinoma in situ, urothelial dysplasia or true invasive urothelial neoplasia. Mitomycin C used after transurethral resection of bladder tumor to reduce recurrences, BCG intravesical immunotherapy to treat high risk non-muscle invasive bladder cancer and urothelial carcinoma in situ, and platinum-based systemic chemotherapy to improve post-cystectomy disease-specific survival some of the causes of therapy related atypia in urinary bladder...
March 14, 2018: Seminars in Diagnostic Pathology
https://www.readbyqxmd.com/read/29569824/determining-the-optimal-time-for-radical-cystectomy-following-neoadjuvant-chemotherapy
#11
Chinedu O Mmeje, Cooper R Benson, Graciela M Nogueras-González, Isuru S Jayaratna, Jianjun Gao, Arlene O Siefker-Radtke, Ashish M Kamat, Colin P Dinney, Neema Navai, Jay B Shah
PURPOSE: To determine whether the recovery window (RW) between neoadjuvant chemotherapy (NAC) and radical cystectomy (RC) affects 90-day post-operative morbidity and incidence of lymph node metastasis. METHODS: We reviewed patients treated with NAC and RC from 1995-2013 for ≤ cT4 N0 M0 bladder cancer. The association of the RW with 90-day perioperative morbidity and lymph node metastasis was determined. Generalized linear models were used to determine predictors of each endpoint...
March 23, 2018: BJU International
https://www.readbyqxmd.com/read/29557251/patient-reported-outcomes-are-associated-with-enhanced-recovery-status-in-patients-with-bladder-cancer-undergoing-radical-cystectomy
#12
Janet Baack Kukreja, Qiuling Shi, Courtney M Chang, Mohamed A Seif, Brandon M Sterling, Ting-Yu Chen, Kelly M Creel, Ashish M Kamat, Colin P Dinney, Neema Navai, Jay B Shah, Xin Shelley Wang
BACKGROUND: Bladder cancer is a disease of the elderly that is associated with high morbidity in those treated with radical cystectomy. In this observational study of patients with bladder cancer undergoing radical cystectomy, we analyzed and compared patient-reported outcomes from those treated with Enhanced Recovery After Surgery (ERAS) methods versus those who received traditional perioperative care. METHODS: We enrolled patients who underwent radical cystectomy at a high-volume tertiary care referral center from November 2013 to December 2016, when the ERAS concept was being introduced into postoperative care at our institution...
March 1, 2018: Surgical Innovation
https://www.readbyqxmd.com/read/29551621/preoperative-incidence-of-deep-venous-thrombosis-in-bladder-cancer-patients-undergoing-radical-cystectomy
#13
John L Schomburg, Suprita Krishna, Katherine J Cotter, Ayman Soubra, Amrita Rao, Badrinath Konety
OBJECTIVES: To determine the pre-operative incidence of subclinical lower-extremity deep vein thrombosis (DVT), as well as to evaluate the utility of preoperative DVT screening in bladder cancer patients prior to undergoing radical cystectomy. MATERIALS AND METHODS: Beginning in 2014, we prospectively instituted a policy of obtaining a screening lower-extremity duplex ultrasound on all patients within 7 days prior to undergoing radical cystectomy. We reviewed the electronic medical records of all patients at our institution who underwent radical cystectomy for bladder cancer from January 2012 through December 2015...
March 15, 2018: Urology
https://www.readbyqxmd.com/read/29551404/unconventional-bladder-preservation-factors-predicting-failure-to-receive-definitive-surgery-following-chemotherapy-for-non-metastatic-muscle-invasive-bladder-cancer-within-the-national-cancer-database
#14
Akash A Kapadia, Ann Martinez Acevedo, Jen-Jane Liu, Mark Garzotto, Michael Conlin, Christopher Amling, Ryan P Kopp
PURPOSE: Neoadjuvant chemotherapy is an important adjunct to cystectomy in management of muscle invasive bladder cancer. We investigated factors that predict failure to receive surgery following multi-agent chemotherapy for non-metastatic muscle invasive bladder cancer utilizing the National Cancer Database. MATERIALS AND METHODS: We performed a cohort study including patients diagnosed with cT2-4aN0M0 urothelial cell carcinoma of the bladder between 2004 and 2013 who underwent multi-agent chemotherapy...
March 15, 2018: Journal of Urology
https://www.readbyqxmd.com/read/29542328/waiting-in-the-wings-the-emerging-role-of-molecular-biomarkers-in-bladder-cancer
#15
Dafina Ilijazi, Mohammad Abufaraj, Melanie R Hassler, Iris E Ertl, David D'Andrea, Shahrokh F Shariat
Bladder cancer (BCa) is the fifth most frequently diagnosed cancer worldwide and is, in fact, the most expensive cancer on a per-patient to treat basis. There is a critical need to implement new tests into clinical practice to improve the quality of clinical care, decrease unnecessary invasive therapies and ultimately save costs. Currently, no molecular or genetic biomarker has been widely integrated into daily clinical practice. However, major milestones have been achieved in our understanding of the molecular alterations in BCa that will provide the basis for integrating molecular and genetic biomarkers into clinical decision making to guide management...
March 15, 2018: Expert Review of Molecular Diagnostics
https://www.readbyqxmd.com/read/29538042/the-evolving-genomic-landscape-in-urothelial-cancer
#16
Lara Kujtan, Arif Hussain, Janakiraman Subramanian, Ashiq Masood
PURPOSE OF REVIEW: Recent advances in next-generation sequencing have allowed for detailed molecular analysis of urothelial carcinomas, with potentially significant clinical implications for personalized treatment. Our objective in this review is to highlight studies from the past year that have furthered the understanding of urothelial cancer genomics. RECENT FINDINGS: Recent studies by The Cancer Genome Atlas consortium further characterized urothelial carcinomas via molecular subtyping, and a schema was proposed to match each subtype with potential therapeutic implications...
March 13, 2018: Current Opinion in Oncology
https://www.readbyqxmd.com/read/29510388/acceptance-of-adjuvant-and-neoadjuvant-chemotherapy-in-muscle-invasive-bladder-cancer-in-germany-a-survey-of-current-practice
#17
Serkan Dogan, Martin Hennig, Tanja Frank, Julian P Struck, Angelika Cebulla, Johannes Salem, Hendrik Borgmann, Tobias Klatte, Axel S Merseburger, Mario Kramer, Sebastian L Hofbauer
BACKGROUND: Guidelines support the use of neoadjuvant (NAC) and adjuvant (AC) chemotherapy in muscle-invasive bladder cancer. However, data from North America reported the underutilization of NAC in favor of AC despite the lower level of scientific evidence supporting AC. We aimed to assess current practice patterns of NAC and AC in -Germany. METHODS: A 15-question online survey was developed and sent via email newsletters to members of the -German Association of Urology and of the German Society of Residents in Urology in October 2016 to analyze current practice patterns...
March 6, 2018: Urologia Internationalis
https://www.readbyqxmd.com/read/29475387/choline-phosphate-cytidylyltransferase-%C3%AE-as-a-possible-predictor-of-survival-and-response-to-cisplatin-neoadjuvant-chemotherapy-in-urothelial-cancer-of-the-bladder
#18
Tammer Hemdan, Polat Turker, Per-Uno Malmström, Ulrika Segersten
OBJECTIVES: The aim of this study was to test choline-phosphate cytidylyltransferase-α (CCT-α) protein as a biomarker for neoadjuvant cisplatin chemotherapy response in a bladder tumor setting. MATERIALS AND METHODS: A total of 238 patients with T2-T4 bladder cancer enrolled into two prior randomized trials comparing neoadjuvant cisplatin-based chemotherapy (NAC) plus cystectomy with cystectomy only (no-NAC) were used as discovery and validation cohorts. Protein expression was determined with immunohistochemistry and assessed with Histo (H)-scoring...
February 23, 2018: Scandinavian Journal of Urology
https://www.readbyqxmd.com/read/29432076/neoadjuvant-chemotherapy-followed-by-radical-surgery-versus-concomitant-chemotherapy-and-radiotherapy-in-patients-with-stage-ib2-iia-or-iib-squamous-cervical-cancer-a-randomized-controlled-trial
#19
Sudeep Gupta, Amita Maheshwari, Pallavi Parab, Umesh Mahantshetty, Rohini Hawaldar, Supriya Sastri Chopra, Rajendra Kerkar, Reena Engineer, Hemant Tongaonkar, Jaya Ghosh, Seema Gulia, Neha Kumar, T Surappa Shylasree, Renuka Gawade, Yogesh Kembhavi, Madhuri Gaikar, Santosh Menon, Meenakshi Thakur, Shyam Shrivastava, Rajendra Badwe
Purpose We compared the efficacy and toxicity of neoadjuvant chemotherapy followed by radical surgery versus standard cisplatin-based chemoradiation in patients with locally advanced squamous cervical cancer. Patients and Methods This was a single-center, phase III, randomized controlled trial ( ClinicalTrials.gov identifier: NCT00193739). Eligible patients were between 18 and 65 years old and had stage IB2, IIA, or IIB squamous cervical cancer. They were randomly assigned, after stratification by stage, to receive either three cycles of neoadjuvant chemotherapy using paclitaxel and carboplatin once every 3 weeks followed by radical hysterectomy or standard radiotherapy with concomitant cisplatin once every week for 5 weeks...
February 12, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/29430507/peri-operative-chemotherapy-for-bladder-cancer-a-survey-of-providers-to-determine-barriers-and-enablers
#20
Melanie Walker, R Christopher Doiron, Simon D French, Kelly Brennan, Deb Feldman-Stewart, D Robert Siemens, William J Mackillop, Christopher M Booth
Background: Utilization of chemotherapy for patients with muscle-invasive bladder cancer (MIBC) is low. In earlier qualitative work we used the Theoretical Domains Framework (TDF) to determine barriers and enablers of chemotherapy use. In this project we aimed to determine the prevalence of these barriers and enablers in Canadian physicians. Methods: Practicing Canadian urologists, medical oncologists (MOs) and radiation oncologists (ROs) participated in a specialty-specific web-based quantitative survey to assess potential barriers and enablers to chemotherapy use...
January 20, 2018: Bladder Cancer
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