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Organ preservation is a hallmark of progress in the world of cancer management. For patients with muscle-invasive bladder cancer, the bladder-sparing approach is a well-established alternative to radical cystectomy. Patients undergo cystoscopic evaluation between the induction and consolidation...
A patient with advanced bladder cancer experienced a complete response for 14 months to the drug combination everolimus (Afinitor) and pazopanib (Votrient) in a phase I trial, and genomic profiling of his tumor revealed two alterations that may have caused this exceptional response, according to a...
Fibroblast growth factor receptor (FGFR) inhibitors are an emerging area of interest in cancer therapeutics. Studies presented at the 2014 American Association for Cancer Research (AACR) Annual Meeting in San Diego provided early encouraging data for two investigational pan-FGFR inhibitors for the...
The 19th Annual Conference of the National Comprehensive Cancer Network (NCCN), recently held in Hollywood, Florida, featured a number of scientific posters by member organizations and meeting sponsors. The ASCO Post captured some of the most interesting findings for our readers, including these...
The investigational immunotherapy agent MPDL3280A (also known as anti-PDL1) produced an overall response rate of 43% in a phase I study of patients previously treated for metastatic urothelial bladder cancer whose tumors were characterized as programmed death ligand 1 (PD-L1)-positive. Results of...
The information in this Clinical Trials Resource Guide includes actively recruiting clinical studies for patients with bladder cancer. The list includes randomized and nonrandomized phase 0 to III studies as well as observational clinical trials evaluating new therapies, surgical techniques, and...
We read the letter to the editor in the July 24, 2014, issue of The New England Journal of Medicine entitled, “A Randomized Trial of Robot-Assisted Laparoscopic Radical Cystectomy,” with great interest.1 Provocative Results In the letter, reviewed in this issue of The ASCO Post, Bochner and...
Retrospective analyses indicate that robot-assisted laparoscopic surgery for radical cystectomy in patients with bladder cancer is associated with reduced risk of complications and shorter hospital stay compared with open surgery. In a small single-institution randomized trial reported in a letter...
As reported by Rebouissou and colleagues in Science Translational Medicine, a subset of muscle-invasive bladder cancers that present with a basal-like phenotype is associated with poorer survival, EGFR pathway activation, and sensitivity to EGFR inhibition. Assessment of data from 383 tumors...
Radical cystectomy is the standard therapeutic option for patients with muscle-invasive bladder cancer. However, 5-year overall survival for high-risk patients with pT3, pT4, pN-negative, and pN-positive M0 bladder cancer after radical cystectomy is only about 50% and ranges from 32% in patients...
As reported in the Journal of the National Cancer Institute, Anirban P. Mitra, MD, PhD, of the University of Southern California, and colleagues identified a novel genome-based signature that improves prediction of postcystectomy recurrence in patients with high-risk bladder cancer.1 Use of the...
Treatment of advanced bladder cancer continues to prove challenging, and therapies that offer long-term survival remain elusive. The ASCO Post recently spoke with Derek Raghavan, MD, PhD, FACP, FRACP, FASCO, President of the Levine Cancer Center, Charlotte, North Carolina, about the current state...
A large observational study presented at the 2015 Genitourinary Cancers Symposium in Orlando, Florida, found that adjuvant chemotherapy extended the likelihood of survival in locally advanced bladder cancer compared with observation alone.1 Using three different approaches to propensity scores...
Two separate phase II studies lend support to the concept of antiangiogenesis in advanced bladder cancer. The combination of an antiangiogenic agent and chemotherapy may fulfill an unmet need in this disease, the studies suggest. Both studies were presented at the 2015 Genitourinary Cancers...
Muscle-invasive bladder cancer can be a lethal disease despite curative intent local therapy, with 5-year survival that can be as low as 30% based on the extent of T status and/or lymph node involvement. The use of neoadjuvant chemotherapy with MVAC (methotrexate, vinblastine, doxorubicin, and...
In the European Organisation for Research and Treatment of Cancer (EORTC) 30994 trial, a phase III intergroup study reported in The Lancet Oncology,1 Cora N. Sternberg, MD, FACP, Chief of Medical Oncology at San Camillo and Forlanini Hospitals, Rome, and colleagues found no overall survival...
Two immunotherapy agents show promise in preliminary studies of advanced urothelial bladder cancer: the anti–PD-1 (programmed cell death protein 1) antibody pembrolizumab (Keytruda) and the anti–PD-L1 (programmed cell death ligand 1) antibody atezolizumab. Separate phase I studies of each drug...
The information contained in this Clinical Trials Resource Guide includes actively recruiting clinical studies for patients with genitourinary cancers—prostate, bladder, uterine, and testicular. The trials are investigating genetic biomarkers of cancer; proton beam therapy; allogeneic bone marrow...
While inhibitors of programmed cell death protein 1 (PD-1) or its ligand (PD-L1) are becoming established in melanoma, non–small cell lung cancer, and renal cell carcinoma, their efficacy is also being evaluated in numerous other tumor types, with promising results, according to studies presented...
Although urothelial cancer of the bladder is sensitive to platinum-based chemotherapy, the vast majority of patients treated with these therapies will develop progressive disease within 8 months of treatment, and the median survival is reported to be between 13 and 15 months, according to a new...
At the 2015 European Cancer Congress in Vienna, Austria, early results were announced (Abstract 21LBA) from a pivotal phase II study, IMvigor 210, of the investigational cancer immunotherapy atezolizumab (anti–PD-L1; MPDL3280A) in people with locally advanced or metastatic urothelial...
Although cisplatin-based neoadjuvant chemotherapy before cystectomy is the standard of care for muscle-invasive bladder cancer, only between 25% and 50% of patients achieve a pathologic response. A study investigating biomarkers that can predict response to chemotherapy in patients with...
Available data suggest an increased risk of bladder cancer with pioglitazone treatment for diabetes. In an analysis of Kaiser Permanente Northern California data reported in JAMA, Lewis et al found no significantly increased risk of bladder cancer in patients with diabetes ever using pioglitazone....
In the largest multi-institutional study to date, patients diagnosed with bladder cancer and treated with robot-assisted surgery experienced similar results to those who underwent a traditional open operation, according to research led by scientists at Roswell Park Cancer Institute (RPCI). The ...
Researchers at The University of Texas MD Anderson Cancer Center have discovered that inhibiting the immune receptor protein TLR4 may not be a wise treatment strategy in all cancers, as research now shows TLR4 can either promote or inhibit breast cancer cell growth depending on mutations in...
Patients who received chemotherapy after bladder cancer surgery demonstrated an approximately 30% lower risk of death than those who underwent surgery alone, according to an analysis presented by researchers at the Icahn School of Medicine at Mount Sinai at the 2015 Genitourinary Cancers Symposium, ...
Long-term survival rates following laparoscopic surgery for bladder cancer are comparable to those of open surgery, according to a study published in BJU International. The findings, which come from the largest study to date with long-term follow-up after this type of minimally invasive surgery,...
In the phase III EORTC 30994 trial reported in The Lancet Oncology, Sternberg et al found no overall survival difference between immediate and delayed adjuvant chemotherapy after radical cystectomy in patients with muscle-invasive urothelial carcinoma of the bladder. Immediate treatment was...
As reported in a letter to Nature by Powles et al, the anti–PD ligand-1 (PD-L1) antibody MPDL3280A has shown good activity in patients with metastatic urothelial bladder cancer in a phase I study. Outcomes were best in patients with PD-L1 immunohistochemistry (IHC) expression of 2 or 3 in...
A novel mechanism—similar to how normal tissue stem cells respond to wounding—might explain why bladder cancer stem cells actively contribute to chemoresistance after multiple cycles of chemotherapy drug treatment. Targeting this “wound response” of cancer stem cells can...
As reported in the Journal of the National Cancer Institute, Mitra et al have identified a novel genomic-based signature that improves prediction of postcystectomy recurrence in patients with high-risk bladder cancer. Use of the signature could help guide selection of patients for adjuvant therapy...
In a pooled analysis of prospective Radiation Therapy Oncology Group (RTOG) studies reported in the Journal of Clinical Oncology, Mak et al found good long-term outcomes with bladder-preserving combined-modality therapy for muscle-invasive bladder cancer. Study Details The analysis included 468...
At least 14 million major medical conditions among U.S. adults aged 35 years and older were attributed to cigarette smoking by a study estimating the disease burden of cigarette smoking, which, according to the study’s authors, “remains immense.” Among current and former smokers,...
In a population-based study reported in the Journal of Clinical Oncology, Gupta et al found that radical cystectomy with urinary diversion for bladder cancer is associated with increased risk of bone fracture at any site in Medicare patients. Radical cystectomy and urinary diversion may cause...
In a trial reported in The New England Journal of Medicine, Bochner et al found no difference in complication rates or length of hospital stay with robot-assisted laparoscopic radical cystectomy vs open surgery in patients with bladder cancer. Blood loss was greater and procedure time shorter with...
In a phase I study, the investigational anti–programmed death-ligand 1 (PD-L1) monoclonal antibody MPDL3280A demonstrated promising overall response rates in patients with previously treated metastatic urothelial bladder cancer whose tumors were characterized as PD-L1–positive. The ...
Although neoadjuvant cisplatin-based chemotherapy is standard of care for muscle-invasive bladder cancer, it is not widely used due to concerns over toxicity and delayed cystectomy. In a phase II trial reported in the Journal of Clinical Oncology, Plimack et al evaluated whether a neoadjuvant...
In a phase II trial reported in the Journal of Clinical Oncology, Choueiri et al found that a neoadjuvant four-cycle/8-week regimen of dose-dense methotrexate, vinblastine, doxorubicin, and cisplatin was well tolerated and effective in patients with muscle-invasive urothelial cancer. Study Details ...
A recent study published in Cancer found that, contrary to treatment guidelines for high-risk bladder cancer, neoadjuvant chemotherapy is not commonly used in routine clinical practice. Utilization of adjuvant chemotherapy was found to be increasing over time and was associated with a substantial...
A new study by Andrew et al published in BJU International suggests that certain inherited DNA sequences may affect the prognosis of patients with bladder cancer. The findings may help physicians identify subgroups of patients with high-risk bladder cancer who should receive more frequent...
A DNA methylation marker test performed on patients with noninvasive urothelial carcinoma can predict tumor recurrence with high sensitivity and specificity, according to a study by Su et al. The findings may help eliminate costly and unnecessary invasive exams and reveals the importance of DNA...
A phase I study by Wagle et al of a combination of everolimus and pazopanib in patients with advanced solid tumors has identified a patient with bladder cancer who had a 14-month complete response. The patient had two concurrent mutations in mTOR, the target of everolimus (Afinitor), which may have ...
Using whole-genome mRNA-expression profiling, researchers have identified three molecular subtypes of muscle-invasive bladder cancers that shared molecular features with basal and luminal breast cancers. The findings have important implications for prognostication, the future clinical development...
Bladder-sparing approaches are typically reserved for patients with bladder cancer who have a complete response to combined modality induction therapy (radiation plus chemotherapy). A new phase II study suggests that patients with near-complete response should also be considered for bladder-sparing ...
Investigators with The Cancer Genome Atlas Research Network have identified new potential therapeutic targets for urothelial carcinoma of the bladder, a common cancer that causes about 150,000 deaths worldwide each year. The researchers also found molecular similarities to some subtypes of breast,...
An international research team led by scientists from Georgetown Lombardi Comprehensive Cancer Center has discovered a genetic mutation linked to low-risk bladder cancer. The findings, published in Nature Genetics, identified STAG2 as one of the most commonly mutated genes in bladder cancer,...
Standard and reduced high-dose volume radiation therapy for muscle-invasive bladder cancer provide comparable tumor control and decreased late toxicity when compared to surgery, according to a study published in the October issue of the International Journal of Radiation Oncology...
Patients with bladder cancer are two times more likely to have complications after a radical cystectomy procedure if they have a biomarker for poor nutritional status before the operation, according to study findings presented at the 2013 Clinical Congress of the American College of Surgeons....
In a phase II study reported in Lancet Oncology, Timur Mitin, MD, of Massachusetts General Hospital, and colleagues assessed the effects of adding paclitaxel or fluorouracil (5-FU) to radiation therapy plus cisplatin followed by adjuvant chemotherapy in a program of selected bladder preservation in ...
Patients with advanced bladder cancers that are surgically removed might need additional therapy to prevent recurrence in certain situations, a new UT Southwestern Medical Center study suggests. The 5-year international study led by researchers at UT Southwestern validates the use of a marker...