Treatment of MIBC - Neoadjuvant Chemotherapy: New Standard of Care
Korean Journal of Urological Oncology
;
: 66-74, 2015.
Artículo
en Coreano
| WPRIM
| ID: wpr-65726
ABSTRACT
The standard management for patients with muscle invasive bladder cancer (MIBC) involves radical cystectomy and pelvic lymph node dissection. Although this treatment may be curative, a large proportion of patients will develop recurrence and will ultimately die of metastatic disease. Prospective, randomized clinical trial data demonstrate a survival advantage for those patients who receive neoadjuvant chemotherapy (NAC) prior to radical cystectomy and this concept was confirmed by meta-analysis. The administration of cisplatin-based combination NAC has consistently demonstrated a survival benefit of 5%. The pathologic downstaging is used as a surrogate end point. The efficacy of NAC for MIBC was established primarily with methotrexate, vinblastine, doxorubicin, and cisplatin (MVAC), with complete response rates (pT0) as high as 38%. Dose dense M-VAC (DDMAVC) is preferred over standard MVAC, and gemcitabine/cisplatin is a reasonable alternative to standard M-VAC for NAC. In Korea, while NAC use has slowly increased over time, it remains an underutilized therapeutic approach in Korean clinical practice.
Texto completo:
Disponible
Índice:
WPRIM (Pacífico Occidental)
Asunto principal:
Recurrencia
/
Vinblastina
/
Neoplasias de la Vejiga Urinaria
/
Biomarcadores
/
Doxorrubicina
/
Cistectomía
/
Metotrexato
/
Estudios Prospectivos
/
Cisplatino
/
Terapia Neoadyuvante
Tipo de estudio:
Ensayo Clínico Controlado
/
Estudio observacional
Límite:
Humanos
País/Región como asunto:
Asia
Idioma:
Coreano
Revista:
Korean Journal of Urological Oncology
Año:
2015
Tipo del documento:
Artículo
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