Neoadjuvant chemotherapy in muscle-invasive bladder cancer: Ready for prime time?
A partir d'une revue de la littérature publiée entre 1998 et 2012, cette étude évalue l'intérêt d'une chimiothérapie néoadjuvante chez des patients atteints d'un carcinome invasif de la vessie
Through a Medline search from January 1, 1998 to February 29, 2012, the literature data supporting the standard use of neoadjuvant or adjuvant chemotherapy in the perioperative setting for muscle-invasive transitional cell carcinoma of the bladder were reviewed. Randomized phase III trials and meta-analyses have shown a significant benefit (level I evidence) in overall survival for neoadjuvant chemotherapy, with a 5% absolute benefit at 5 years, provided cisplatin-based combination regimens are used. Major methodological biases preclude any firm conclusion regarding the routine use of adjuvant therapy. The optimal chemotherapy regimen remains to be determined. Predictive biomarkers are urgently needed in order to determine which patients are more likely to benefit from neoadjuvant chemotherapy.
http://www.sciencedirect.com/science/article/pii/S104084281200176X