Bladder Cancer

Although chemotherapy and radical cystectomy are traditionally used to treat muscle-invasive disease, a recent analysis shows similar overall survival outcomes in patients treated with chemoradiotherapy.

Older adults may be at an increased risk for a heart attack or stroke five months before they are even diagnosed with cancer – a risk that peaked in the month prior to diagnosis, according to a report published in Blood.

A recent meta-analysis has found no noticeable difference in immunotherapy’s efficacy based on patient sex.

While the treatment landscape continues to grow in bladder cancer, researchers should continue to follow the evidence, but accrual of patients in clinical trials is also key, according to Petros Grivas, M.D., Ph.D.

Patients with muscle-invasive bladder cancer who were treated with a dose-dense regimen of neoadjuvant chemotherapy followed by radical cystectomy (surgery to remove the urinary bladder) experienced more complete responses to treatment compared with the current standard of neoadjuvant chemotherapy.

The treatment paradigm for bladder cancer has been quite exciting in the last few years, and even more is yet to come, according to Petros Grivas, M.D., Ph.D.

Although immunotherapies show promise for patients, there are still challenges ahead.

Patients with platinum-pretreated metastatic urothelial carcinoma who were treated with a higher dosage of Yervoy (ipilimumab) in combination with Opdivo (nivolumab) experienced improved survival and tolerable side effects, according to findings from the phase 1/2 CheckMate-032 trial.

The immunotherapy agent Keytruda is showing promise for treating non-muscle invasive bladder cancer, according to a recent study.

In a recent survey, individuals in remission reported a more positive experience with bladder cancer compared with their counterparts who currently have active disease.

While universal screening for Lynch syndrome is currently only recommended for patients with colorectal and endometrial cancers, a new study recently published in The American Journal of Surgical Pathology suggests this for patients with upper tract urothelial carcinoma, too.

Can providers decrease opioid prescriptions after surgery, while still managing care adequately?

Immunotherapy has been a buzzworthy topic in the field of bladder cancer over the last couple of years. However, according to a Food and Drug Administration (FDA) safety warning, patients with metastatic disease may need to have their treatment altered.

Immunotherapy pioneers James P. Allison and Dr. Tasuku Honjo have won the 2018 Nobel Prize in Physiology or Medicine for their research that eventually led to the use of immune checkpoint inhibitors to treat cancer.

Researchers determined that the use of methotrexate, vinblastine, doxorubicin and cisplatin before cystectomy may induce better outcomes for patients with advanced bladder cancer.

A new test that identifies which bladder cancer tumors will become invasive could help reduce health care costs and over-treatment in patients.

Stromal cells – known to provide structure to one’s organs – found in bladder cancer may explain why some patients do not respond to Opdivo (nivolumab) treatment.

Some patients eligible for bladder surgery due to cancer may safely opt to preserve the organ.

After chemotherapy, immunotherapy has become the standard treatment for bladder cancer. Will it ever play a bigger role?

While there is currently no definitive way to predict who will respond and who will not, researchers at Brighton and Sussex Medical School in the United Kingdom are working on a blood test that could identify about half of those who may not.

CURE spoke with Matthew Mossanen, M.D., from the Division of Urology at Brigham and Women’s Hospital, about what Bacillus Calmette-Guérin (BCG) is and what patients should know about this treatment option.

The Food and Drug Administration (FDA) updated the prescribing information for two immunotherapy agents – Keytruda (pembrolizumab) and Tecentriq (atezolizumab) – approved to treat patients with locally advanced or metastatic bladder cancer who are not eligible for cisplatin-based therapy.

With five immunotherapy drugs approved in the bladder cancer space, the next question researchers find themselves asking is whether these drugs would work better alone or as part of a combination for patients with metastatic disease.

Creating a medical family tree is helpful. If cancer is common, noting which branches include it can help inform decisions.

Women are more likely to die from bladder cancer earlier on after diagnosis, according to recent study findings published in the European Journal of Cancer. However, after that time frame the risk of death is higher for men.

Many questions still remain in the treatment of localized bladder cancer, like which patients are best suited to receive neoadjuvant (pre-surgery) chemotherapy – a procedure that could be beneficial to many, but comes with increased toxicity.

Because little is known about the effect of patients' sex on the efficacy of immune checkpoint inhibitors as cancer treatments, the researchers performed a systematic review and meta-analysis to determine the heterogeneity of immune checkpoint inhibitor efficacy between men and women.

Immunotherapy is being tested in the second-line setting for metastatic bladder cancer. Pending trial results, the role of chemotherapy for this patient population may change.

Phase 2 study results showed that patients with metastatic or unresectable, FGFR-positive bladder cancer may have a third-line option for treatment.

The FDA has incorporated PD-L1 status into the labels for Keytruda (pembrolizumab) and Tecentriq (atezolizumab) for existing frontline approvals for platinum-ineligible patients with urothelial carcinoma, based on lower overall survival (OS) rates with the PD-1/PD-L1 inhibitors compared with platinum-based chemotherapy for patients with PD-L1–low expressing platinum-eligible urothelial carcinoma.