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Neoadjuvant accelerated MVAC therapy in bladder cancer: toxicity and efficacy correlation

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American Journal of BioMedicine  Volume 2, Issue 7, pages 782-798, July 2014


William M. Grabstald; Richard H. Sarkis; Chrisophos A. Jacobus;  Smith V. Feifer

Abstract

Bladder cancer is the second most common cancer of the genitourinary tract. Radical cystectomy is considered the gold standard of treatment for patients with localized muscle-invasive disease (MIBC), although chemoradiotherapy protocols using neoadjuvant cisplatin-based chemotherapy is used for muscle-invasive bladder cancer. We explored the toxicity and efficacy of neoadjuvant AMVAC in MIBC. A total of 177 patients with clinical tumor–node–metastases (TNM) stage T2N0M0 to T4aN0M0 bladder cancer who were candidates for radical cystectomy were eligible, tumors were staged according to the criteria in the fourth edition of the American Joint Committee on Cancer staging manual. Grade ≥ 2 toxicities were observed in 8% of patients, with grade 3 and 4 neutropenia in 7% and 5% patients, respectively; grade 3 and 4 anemia in 4% and 2% of patients, respectively; no patients died of drug toxicity; 61% of patients were accrued; 16% were down-staged to non–muscle invasive disease. Further, 31% showing pT0 at cystectomy and the median survival was 16.9 months.

 Keywords: Bladder cancer; MIBC; neoadjuvant; AMVAC; Toxicity and efficacy


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