Current guidelines recommend cisplatin-based neoadjuvant chemotherapy prior to radical cystectomy as the preferred treatment of muscle-invasive bladder cancer. Nevertheless, for multiple reasons compliance with this guideline recommendation is low. This is particularly evident in clinical T2 bladder cancer, where controversy exists regarding the role of proceeding with radical cystectomy alone. Novel biomarkers such as molecular phenotype and DNA damage repair and response gene alterations may be able to predict who will respond to cisplatin-based neoadjuvant chemotherapy. This clinical problem is discussed, and a recommendation is made given the current state of the art. PATIENT SUMMARY: Neoadjuvant chemotherapy improves survival for patients with muscle-invasive bladder cancer. In the future, perhaps validated biomarkers may predict who should and should not receive this treatment.
European urology oncology. 2019 Jul 03 [Epub ahead of print]
H Barton Grossman, Joaquim Bellmunt, Peter C Black
MD Anderson Cancer Center, University of Texas, Houston, TX, USA. Electronic address: ., Dana Farber Cancer Institute, Boston, MA, USA., The University of British Columbia, Vancouver, Canada.