SEOM clinical guideline for treatment of muscle-invasive and metastatic urothelial bladder cancer (2018)
Clin. transl. oncol. (Print)
; 21(1): 64-74, ene. 2019. tab
Article
em En
| IBECS
| ID: ibc-183345
Biblioteca responsável:
ES1.1
Localização: BNCS
ABSTRACT
The goal of this article is to provide recommendations about the management of muscle-invasive (MIBC) and metastatic bladder cancer. New molecular subtypes of MIBC are associated with specific clinical-pathological characteristics. Radical cystectomy and lymph node dissection are the gold standard for treatment and neoadjuvant chemotherapy with a cisplatin-based combination should be recommended in fit patients. The role of adjuvant chemotherapy in MIBC remains controversial; its use must be considered in patients with high-risk who are able to tolerate a cisplatin-based regimen, and have not received neoadjuvant chemotherapy. Bladder-preserving approaches are reasonable alternatives to cystectomy in selected patients for whom cystectomy is not contemplated either for clinical or personal reasons. Cisplatin-based combination chemotherapy is the standard first-line protocol for metastatic disease. In the case of unfit patients, carboplatin-gemcitabine should be considered the preferred first-line chemotherapy treatment option, while pembrolizumab and atezolizumab can be contemplated for individuals with high PD-L1 expression. In cases of progression after platinum-based therapy, PD-1/PD-L1 inhibitors are standard alternatives. Vinflunine is another option when anti-PD-1/PD-L1 therapy is not possible. There are no data from randomized clinical trials regarding moving on to immuno-oncology agents
RESUMEN
No disponible
Texto completo:
1
Coleções:
06-national
/
ES
Base de dados:
IBECS
Assunto principal:
Neoplasias da Bexiga Urinária
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Carcinoma de Células de Transição
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Neoplasias Musculares
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Antineoplásicos Imunológicos
/
Antineoplásicos
Limite:
Humans
Idioma:
En
Revista:
Clin. transl. oncol. (Print)
Ano de publicação:
2019
Tipo de documento:
Article