title: Management of advanced bladder cancer in patients with impaired renal function.
abstract: Advanced transitional-cell carcinoma of the bladder is the most common cancer of the urinary tract, with a high mortality rate. Cisplatin-based chemotherapy has demonstrated prolonged survival of these patients and is considered the standard of care. Nevertheless, 40-50% of patients have impaired renal function that precludes the use of cisplatin. The non-nephrotoxic platinum analogue, carboplatin, has emerged as the most popular alternative in this setting, used mainly in doublets. However, it has not shown similar efficacy to cisplatin. In this article, platinum-based or platinum-free regimens, monotherapies or combination therapies are discussed as treatment options for this population. Their efficacy and toxicity are also being analyzed. The study of newer targeted therapies in the treatment of bladder cancer is also discussed, as are future perspectives and a five-year view in the treatment of the disease in patients with renal impairment.
authors.affiliation: Department of Clinical Therapeutics, Medical School, University of Athens, 80 Vasilissis Sofias Ave, Athens, Greece.
authors.forename: Evangelos
authors.initials: E
authors.lastname: Bournakis
authors.forename: Meletios A
authors.initials: MA
authors.lastname: Dimopoulos
authors.forename: Aristotle
authors.initials: A
authors.lastname: Bamias
mesh_terms: D000818:Animals; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002295:Carcinoma, Transitional Cell / Q000188:drug therapy* / Q000473:pathology; D002945:Cisplatin / Q000008:administration & dosage; D016503:Drug Delivery Systems; D006801:Humans; D051437:Renal Insufficiency / Q000150:complications / Q000209:etiology; D015996:Survival Rate; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy* / Q000473:pathology
chemical_list: D002945:Cisplatin