title: Improving Systemic Chemotherapy for Bladder Cancer.
abstract: Systemic chemotherapy is integral to the management of muscle-invasive and metastatic bladder cancer (BCa). Neoadjuvant chemotherapy has been increasingly utilized for muscle-invasive BCa over the past several years, and several options for cisplatin-based regimens have emerged. Adjuvant chemotherapy may be considered for select patients who did not receive neoadjuvant therapy. Systemic chemotherapy added to radiotherapy is a critical component of a bladder-preserving approach and superior to radiotherapy alone. Cisplatin-based chemotherapy has been the mainstay for metastatic BCa for more than three decades. Novel targeted agents are in development fueled by the recent molecular characterization of BCa. Recent trials of immunotherapy have demonstrated the possibility of a less toxic and potentially more effective treatment for metastatic disease. It is an extremely exciting time for BCa research, and much needed improvements in systemic treatment are most certainly on the horizon.
authors.affiliation: Division of Hematology/Oncology, Department of Medicine, University of North Carolina Lineberger Comprehensive Cancer Center, 170 Manning Drive, CB #7305, 27599, Chapel Hill, NC, USA.
authors.forename: Tracy L
authors.initials: TL
authors.lastname: Rose
authors.affiliation: Division of Hematology/Oncology, Department of Medicine, University of North Carolina Lineberger Comprehensive Cancer Center, 170 Manning Drive, CB #7295, 27599, Chapel Hill, NC, USA. matt_milowsky@med.unc.edu.
authors.forename: Matthew I
authors.initials: MI
authors.lastname: Milowsky
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D035843:Biomedical Research / Q000379:methods / Q000639:trends; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D006801:Humans; D007167:Immunotherapy; D020360:Neoadjuvant Therapy; D011878:Radiotherapy; D001749:Urinary Bladder Neoplasms / Q000473:pathology / Q000628:therapy*
chemical_list: D002945:Cisplatin
keywords: Adjuvant therapy; Biologic agents; Bladder cancer; Chemotherapy; Immunotherapy; Molecular biology; Neoadjuvant therapy; Personalized therapy; Prognostic factors; Targeted agents; Transitional cell carcinoma; Trimodality therapy; Urothelial carcinoma