Search

This research letter discusses the outcomes of patients with muscle-invasive bladder cancer who received neoadjuvant chemotherapy (NAC) followed by radical cystectomy (RC) compared to those who only underwent RC. The study found that patients with residual locally advanced cancer after NAC had poor outcomes, and those with ypT3/T4 or N+ disease had worse prognosis compared to patients who only underwent RC. The study suggests the need for better selection criteria for NAC and the exploration of novel systemic therapies for high-risk patients. However, the study is limited by its retrospective nature and lack of detailed information on chemotherapy regimens. [Extracted from the article]

Purpose of Review: Several novel therapies approved by the Food and Drug Administration (FDA) and explosion of clinical trials have changed the landscape Bacillus Calmette-Guérin (BCG)-unresponsive nonmuscle invasive bladder cancer (NMIBC). Given the recent advancements in bladder sparing options, the role of radical cystectomy (RC) in BCG-unresponsive NMIBC remains a subject of debate., Recent Findings: All three novel agents currently approved by the FDA for BCG-unresponsive NMIBC have strict indication [carcinoma in situ (CIS)], low response rate, and short response duration. Some promising new agents are awaiting results and/or FDA approval. RC still provides the best oncologic control and acceptable quality of life, and potentially represents the most cost-effective option., Summary: It is an exciting time for the urologic oncology community to see the FDA approvals of some of the novel bladder sparing therapies and expansion of ongoing clinical trials. Yet, RC should still be considered as the gold standard of BCG-unresponsive NMIBC. We also must be cautious and selective in recommending bladder sparing options for patients with BCG-unresponsive NMIBC., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)