Neo-adjuvant chemotherapy for muscle-invasive bladder cancer: a look ahead

Randomized clinical trials of neo-adjuvant cisplatin-based combination chemotherapy for locally advanced muscle invasive bladder cancer has shown a survival benefit over cystectomy alone. Pathologic complete response (pT0) after neo-adjuvant chemotherapy is emerging as a potentially important surrogate clinical end point. Future clinical trials incorporating targeted therapies with novel clinical end points may accelerate development of therapeutic strategies for locally advanced muscle invasive bladder cancer. Furthermore, evaluation of molecular markers may further help to stratify patients to a risk adapted approach.