Management of Advanced Bladder Cancer: An Update

Bladder cancer is the sixth most common cancer in the United States; therefore, the majority of clinicians working in the oncology setting will care for this patient population. Unfortunately, treatment plans, especially in the advanced setting, lack consistency. This, along with the advanced age and comorbidities of most bladder cancer patients, can provide challenges for clinicians when developing treatment plans. In the past 2 years, new drug approvals, specifically those for immune checkpoint inhibitors, have changed the treatment landscape for bladder cancer for the first time since the 1980s. This review article outlines the current management for muscle-invasive and metastatic bladder cancer, while also highlighting future considerations in this disease space. It is imperative that oncology advanced practice providers are up to date with these new changes and have a sound understanding of treatment principles for patients with advanced bladder cancer in order to deliver the safest and most effective care.

[1]  S. Culine,et al.  Pembrolizumab as Second‐Line Therapy for Advanced Urothelial Carcinoma , 2017, The New England journal of medicine.

[2]  Geoffrey E. Wile,et al.  NCCN Guidelines Insights: Bladder Cancer, Version 2.2016. , 2016, Journal of the National Comprehensive Cancer Network : JNCCN.

[3]  H. Reis,et al.  Clinical, prognostic, and therapeutic aspects of urachal carcinoma-A comprehensive review with meta-analysis of 1,010 cases. , 2016, Urologic oncology.

[4]  D. Hansel,et al.  The Emerging Molecular Landscape of Urothelial Carcinoma. , 2016, Surgical pathology clinics.

[5]  Holger Moch,et al.  The 2016 WHO Classification of Tumours of the Urinary System and Male Genital Organs-Part B: Prostate and Bladder Tumours. , 2016, European urology.

[6]  R. Bourgon,et al.  Atezolizumab in patients with locally advanced and metastatic urothelial carcinoma who have progressed following treatment with platinum-based chemotherapy: a single-arm, multicentre, phase 2 trial , 2016, The Lancet.

[7]  Jianjun Gao,et al.  The State of Immune Checkpoint Inhibition in Urothelial Carcinoma: Current Evidence and Future Areas of Exploration , 2016, Cancer journal.

[8]  M. Munsell,et al.  Front-line Treatment with Gemcitabine, Paclitaxel, and Doxorubicin for Patients With Unresectable or Metastatic Urothelial Cancer and Poor Renal Function: Final Results from a Phase II Study. , 2016, Urology.

[9]  B. Czerniak,et al.  Therapeutic opportunities in the intrinsic subtypes of muscle-invasive bladder cancer. , 2015, Hematology/oncology clinics of North America.

[10]  R. Mak,et al.  Long-term outcomes in patients with muscle-invasive bladder cancer after selective bladder-preserving combined-modality therapy: a pooled analysis of Radiation Therapy Oncology Group protocols 8802, 8903, 9506, 9706, 9906, and 0233. , 2014, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[11]  P. Kantoff,et al.  Neoadjuvant dose-dense methotrexate, vinblastine, doxorubicin, and cisplatin with pegfilgrastim support in muscle-invasive urothelial cancer: pathologic, radiologic, and biomarker correlates. , 2014, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[12]  S. Boorjian,et al.  Accelerated methotrexate, vinblastine, doxorubicin, and cisplatin is safe, effective, and efficient neoadjuvant treatment for muscle-invasive bladder cancer: results of a multicenter phase II study with molecular correlates of response and toxicity. , 2014, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[13]  M. Munsell,et al.  Gemcitabine, paclitaxel, and doxorubicin for patients (pts) with urothelial carcinoma (UC) and renal insufficiency: Preliminary results of a multicenter phase II study. , 2011, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[14]  P. Thall,et al.  Phase II clinical trial of neoadjuvant alternating doublet chemotherapy with ifosfamide/doxorubicin and etoposide/cisplatin in small-cell urothelial cancer. , 2009, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[15]  V. Reuter,et al.  Urachal Carcinoma: A Clinicopathologic Analysis of 24 Cases With Outcome Correlation , 2009, The American journal of surgical pathology.

[16]  H. Kantarjian,et al.  The MD Anderson Manual of Medical Oncology , 2006 .

[17]  Sergio Ricci,et al.  Long-term survival results of a randomized trial comparing gemcitabine plus cisplatin, with methotrexate, vinblastine, doxorubicin, plus cisplatin in patients with bladder cancer. , 2006, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[18]  C. Vale.  Neoadjuvant Chemotherapy in Invasive Bladder Cancer: Update of a Systematic Review and Meta-Analysis of Individual Patient Data: Advanced Bladder Cancer (ABC) Meta-analysis Collaboration , 2005 .

[19]  S. Ricci,et al.  Long-Term Survival Results of a Randomized Trial Comparing Gemcitabine Plus Cisplatin, With Methotrexate, Vinblastine, Doxorubicin, Plus Cisplatin in Patients With Bladder Cancer , 2005 .

[20]  Nicholas J Vogelzang,et al.  Neoadjuvant chemotherapy plus cystectomy compared with cystectomy alone for locally advanced bladder cancer. , 2003, The New England journal of medicine.

[21]  R. Millikan,et al.  Multimodality management of urachal carcinoma: the M. D. Anderson Cancer Center experience. , 2003, The Journal of urology.

[22]  H. Burstein,et al.  NCCN CLINICAL PRACTICE GUIDELINES IN ONCOLOGY , 2019 .

[23]  J. Witjes,et al.  MUSCLE-INVASIVE AND METASTATIC BLADDER CANCER , 2016 .

[24]  H. Ozen.  Bladder cancer. , 1998, Current opinion in oncology.