Advanced bladder cancer: status of first-line chemotherapy and the search for active agents in the second-line setting.
Urothelial carcinoma (UC) remains a significant health problem affecting an estimated 68,810 people in 2008 alone in the US. The majority of patients with metastatic disease develop disease recurrence, and long-term survival rates are poor. There is no standard of care for the treatment of patients with UC after the failure of cisplatin-based regimens in the first-line setting. Efforts to improve second-line treatment have led to the evaluation of single agents such as vinflunine and pemetrexed, and multidrug combinations with cytotoxic and targeted agents, including trastuzumab and bevacizumab. The authors reviewed the activity of several single agents and combination regimens in patients with UC. Emerging strategies for the measurement of response in clinical trials were also outlined.
Gallagher
David J
DJ
Genitourinary Oncology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA. gallaghd@mskcc.org
Milowsky
Matthew I
MI
Bajorin
Dean F
DF
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000188:drug therapy*; D016879:Salvage Therapy; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy* / Q000473:pathology