title: Neoadjuvant therapy in muscle-invasive bladder cancer: a model for rational accelerated drug development.
abstract: Since the advent of cisplatin-based combination therapy in the management of muscle-invasive and advanced bladder cancer, there has been little progress in improving outcomes for patients. Novel therapies beyond cytotoxic chemotherapy are needed. The neoadjuvant paradigm lends to acquiring ample pretreatment and posttreatment tumor tissue as a standard of care, which enables comprehensive biomarker analyses to better understand mechanisms of both response and resistance, which will aid drug development. This article discusses the evolution of neoadjuvant therapy as standard treatment and the role it may serve toward the development of novel therapies.
authors.affiliation: Genitourinary Cancers Program, Perlmutter NYU Cancer Center, 160 East 34th Street, 8th Floor, New York, NY 10016, USA. Electronic address: arjun.balar@nyumc.org.
authors.forename: Arjun V
authors.initials: AV
authors.lastname: Balar
authors.affiliation: Genitourinary Oncology, Urologic Oncology Program, UNC Lineberger Comprehensive Cancer Center, 3rd Floor Physician's Office Building, 170 Manning Drive, Chapel Hill, NC 27599, USA.
authors.forename: Matthew I
authors.initials: MI
authors.lastname: Milowsky
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D015653:Cystectomy; D004317:Doxorubicin / Q000008:administration & dosage; D055808:Drug Discovery; D006801:Humans; D008727:Methotrexate / Q000008:administration & dosage; D020360:Neoadjuvant Therapy / Q000379:methods*; D009361:Neoplasm Invasiveness; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000473:pathology / Q000628:therapy*; D014747:Vinblastine / Q000008:administration & dosage
chemical_list: D014747:Vinblastine; D004317:Doxorubicin; D002945:Cisplatin; D008727:Methotrexate
keywords: Bladder cancer; Cisplatin; Immunotherapy; Neoadjuvant chemotherapy; Predictive biomarkers; The Cancer Genome Atlas; Urothelial cancer