Bladder preservation after neoadjuvant therapy - 2021 IBCN updates part 1

Area of Science:

• Oncology
• Urology

Background:

• Radical cystectomy (RC) for muscle-invasive bladder cancer (MIBC) is associated with significant morbidity.
• Bladder preservation strategies are being explored following neoadjuvant therapy (NAT).

Purpose of the Study:

• To review the accuracy of staging modalities for MIBC after NAT.
• To investigate clinical outcomes of bladder preservation in MIBC patients.
• To discuss the role of DNA damage response (DDR) gene alterations in predicting treatment response.

Main Methods:

• Review of contemporary staging modalities.
• Analysis of clinical outcomes in MIBC patients undergoing bladder preservation post-NAT.
• Evaluation of the predictive value of DDR gene alterations.

Main Results:

• Contemporary staging modalities have limitations in accurately assessing MIBC post-NAT.
• Bladder preservation after NAT shows promising clinical outcomes in selected MIBC patients.
• Cisplatin-sensitizing DDR gene alterations are crucial for identifying suitable candidates.

Conclusions:

• Accurate staging and identification of cisplatin sensitivity are critical for successful bladder preservation in MIBC.
• DDR gene alterations hold predictive value and are foundational to ongoing clinical trials for bladder preservation.