SEOM-SOGUG clinical guideline for localized muscle invasive and advanced bladder cancer (2021)
Clin. transl. oncol. (Print)
; 24(4): 613-624, abril 2022.
Article
in English
| IBECS
| ID: ibc-203765
Responsible library:
ES1.1
Localization: ES15.1 - BNCS
ABSTRACT
Most muscle-invasive bladder cancer (BC) are urothelial carcinomas (UC) of transitional origin, although histological variants of UC have been recognized. Smoking is the most important risk factor in developed countries, and the basis for prevention. UC harbors high number of genomic aberrations that make possible targeted therapies. Based on molecular features, a consensus classification identified six different MIBC subtypes. Hematuria and irritative bladder symptoms, CT scan, cystoscopy and transurethral resection are the basis for diagnosis. Radical cystectomy with pelvic lymphadenectomy is the standard approach for muscle-invasive BC, although bladder preservation is an option for selected patients who wish to avoid or cannot tolerate surgery. Perioperative cisplatin-based neoadjuvant chemotherapy is recommended for cT2-4aN0M0 tumors, or as adjuvant in patients with pT3/4 and or pN + after radical cystectomy. Follow-up is particularly important after the availability of new salvage therapies. It should be individualized and adapted to the risk of recurrence. Cisplatingemcitabine is considered the standard first line for metastatic tumors. Carboplatin should replace cisplatin in cisplatin-ineligible patients. According to the EMA label, pembrolizumab or atezolizumab could be an option in cisplatin-ineligible patients with high PD-L1 expression. For patients whose disease respond or did not progress after first-line platinum chemotherapy, maintenance with avelumab prolongs survival with respect to the best supportive care. Pembrolizumab also increases survival versus vinflunine or taxanes in patients with progression after chemotherapy who have not received avelumab, as well as enfortumab vedotin in those progressing to first-line chemotherapy followed by an antiPDL1/PD1. Erdafitinib may be considered in this setting in patients with FGFR alterations. An early onset of supportive and palliative care is always strongly recommended.
Full text:
Available
Collection:
National databases
/
Spain
Database:
IBECS
Main subject:
Urinary Bladder Neoplasms
/
Carcinoma, Transitional Cell
/
Antineoplastic Combined Chemotherapy Protocols
/
Cisplatin
Limits:
Humans
Language:
English
Journal:
Clin. transl. oncol. (Print)
Year:
2022
Document type:
Article
Institution/Affiliation country:
Complejo Hospitalario Universitario Insular-Materno Infantil/Spain
/
Complejo Hospitalario Universitario/Spain
/
Hospital Fundació Althaia/Spain
/
Hospital General Universitario Gregorio Marañón/Spain
/
Hospital General Universitario de Valencia/Spain
/
Hospital Universitario Lucus Augusti/Spain
/
Hospital Universitario Puerta de Hierro Majadahonda/Spain
/
Hospital Universitario Virgen del Rocío/Spain
/
Hospital Universitario de Cabueñes/Spain
/
Vall dHebron Institute of Oncology/Spain