Chemotherapy for Muscle-Invasive Bladder Cancer

Area of Science:

• Oncology
• Urology
• Cancer Research

Background:

• Significant advancements in understanding muscle-invasive bladder cancer (BC) pathogenesis over 25 years.
• Evolution from single-agent platinum compounds to combination chemotherapy with improved safety and survival.

Purpose of the Study:

• To review the current landscape of bladder cancer treatment strategies.
• To highlight the role of chemotherapy and emerging therapies like immunotherapy.

Main Methods:

• Review of clinical evidence and treatment guidelines for bladder cancer.
• Discussion of prognostic and predictive tools derived from gene expression profiling (GEP).

Main Results:

• Platinum-based chemotherapy remains the standard for early and advanced bladder cancer.
• Neoadjuvant chemotherapy (NC) shows survival benefits, with adjuvant treatment considered if NC is not used.
• Gene expression profiling (GEP) and immunotherapy show promise for future targeted treatments.

Conclusions:

• Multidisciplinary approach and patient selection are crucial for effective bladder cancer management.
• Immunotherapy is poised to become a pivotal treatment, potentially reducing the role of chemotherapy.
• Ongoing research into BC pathogenesis, including high mutational rates and neoantigens, will drive personalized treatment development.