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What is the real-world impact of perioperative systemic therapy for patients with muscle-invasive bladder cancer (MIBC), and how does this compare with clinical trial results?
Analysis of 2006-2021 data from 47,983 U.S. patients who had radical cystectomy confirmed that standard-of-care cisplatin-based chemotherapy before surgery was associated with significantly higher rates of complete pathologic response and improved overall survival (OS) compared with the rates for patients who had surgery alone.
Sarmad Sadeghi, MD, PhD, of the University of Southern California Norris Comprehensive Cancer Center in Los Angeles, and colleagues reported that with a median follow-up of 81.8 months, median OS was 90.7 months in patients treated with neoadjuvant therapy plus radical cystectomy versus 52 months in those treated with surgery alone. Achievement of partial response to neoadjuvant therapy and treatment at a high-volume surgical center were also associated with increased survival.
In patients who did not have neoadjuvant systemic therapy, the use of adjuvant systemic therapy did not adequately compensate for the loss of OS benefit, the researchers said.
