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Updated: May 5, 2026
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An Orthotopic Bladder Tumor Model and the Evaluation of Intravesical saRNA Treatment
Published on: July 28, 2012
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Neoadjuvant Cisplatin, Gemcitabine, and Docetaxel in Sarcomatoid Bladder Cancer: Clinical Activity and Whole
Burles A Johnson Iii1,2, Benjamin A Teply1,3, Catherine Kagemann1,2
1Johns Hopkins University Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, USA.
Bladder Cancer (Amsterdam, Netherlands)
|August 12, 2024
Summary
Sarcomatoid urothelial cancer of the bladder (SBC) shows promising response to neoadjuvant cisplatin, gemcitabine, and docetaxel (CGD) chemotherapy. Molecular analysis reveals potential therapeutic targets within SBC tumors.
Area of Science:
- Uro-oncology
- Medical oncology
- Genomics
Background:
- Sarcomatoid urothelial cancer of the bladder (SBC) is a rare and aggressive subtype requiring novel treatment strategies.
- Limited therapeutic options exist for muscle-invasive SBC.
Purpose of the Study:
- To evaluate the clinical activity and safety of neoadjuvant cisplatin, gemcitabine, and docetaxel (CGD) chemotherapy in muscle-invasive SBC patients.
- To assess the tumor biology of SBC using whole transcriptome RNA sequencing.
Main Methods:
- Retrospective analysis of 16 muscle-invasive SBC patients treated with neoadjuvant CGD.
- Patients received 4 cycles of CGD followed by cystectomy.
- Whole transcriptome RNA sequencing was performed on tumor samples.
Main Results:
- The pathologic complete response (ypCR) rate was 38%, with 50% of patients achieving a ypT2 or less stage.
- Grade 3/4 toxicity occurred in 80%/40% of patients but was manageable, with 81% completing >3 cycles.
- SBC tumors clustered with conventional urothelial tumors and showed basal-squamous and stroma-rich gene signatures, with increased expression of immune checkpoint (PD-L1), chemokine (CXCL9), and T-cell (CD8A) genes.
Conclusions:
- Neoadjuvant CGD demonstrates chemosensitivity in SBC, achieving ypCR rates comparable to conventional urothelial bladder cancer.
- Whole transcriptome analysis highlights increased expression of immune checkpoint and T-cell genes, suggesting potential therapeutic targets for SBC.
