Neoadjuvant chemotherapy with dose-dense MVAC in muscle-invasive bladder cancer: a tertiary center experience
Clin. transl. oncol. (Print)
; 26(2): 549-553, feb. 2024.
Artículo
en Inglés
| IBECS
| ID: ibc-230199
Biblioteca responsable:
ES1.1
Ubicación: ES15.1 - BNCS
ABSTRACT
Purpose Neoadjuvant chemotherapy in muscle-invasive bladder cancer (MIBC) patients has proven beneficial in overall survival. However, the optimal regimen is still a matter of debate. Materials and method In this retrospective analysis, we evaluate the results obtained in 42 patients treated in our center with 4 cycles of neoadjuvant dose-dense methotrexate, vinblastine, doxorubicin, and cisplatin (dd-MVAC) followed by radical cystectomy from August 2015 to October 2020. All patients had cT2 or higher non-metastatic MIBC. Clinical and pathological outcomes are reported. Results Of the 42 patients, 90.5% were men (n = 38) and the mean age was 65 years. All of them had ECOG 01 at diagnosis and most tumors had an initial clinical stage T2N0 (76%). Thirty-six patients (85.7%) completed 4 cycles of neoadjuvant treatment, and 21.4% required a dose reduction. The most frequent adverse event (AE) was grade 12 asthenia (81%), while neutropenia was the most frequent grade 3 or higher AE (38%). Complete pathological response (ypT0, ypN0) was achieved in 50% of patients (n = 21), and down-staging was observed in 57.1% (n = 24). Only one patient presented radiological progressive disease during neoadjuvant treatment (2.4%), and after a mean follow-up time of 31.5 months, 33.3% of patients experienced disease recurrence. Conclusions Neoadjuvant chemotherapy with 4 cycles of dd-MVAC is an effective regimen with high rates of pathological complete responses and down-staging along with an acceptable toxicity profile. DD-MVAC should be considered as an alternative to cisplatin and gemcitabine in patients with good clinical performance status (AU)
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Colección:
Bases de datos nacionales
/
España
Base de datos:
IBECS
Asunto principal:
Neoplasias de la Vejiga Urinaria
/
Protocolos de Quimioterapia Combinada Antineoplásica
/
Doxorrubicina
/
Cisplatino
/
Terapia Neoadyuvante
/
Desoxicitidina
Límite:
Anciano
/
Femenino
/
Humanos
/
Masculino
Idioma:
Inglés
Revista:
Clin. transl. oncol. (Print)
Año:
2024
Tipo del documento:
Artículo
Institución/País de afiliación:
Hospital Universitario Marqués de Valdecilla/Spain
/
IDIVAL/Spain