Accelerating neoadjuvant chemotherapy for muscle-invasive bladder cancer
Mené en France sur 500 patients atteints d'un cancer de la vessie avec envahissement musculaire (durée médiane de suivi : 5,3 ans), cet essai de phase III compare l'efficacité, du point de vue de la survie globale, et la toxicité de deux stratégies péropératoires, l'une combinant des doses intensifiées de méthotrexate, vinblastine, doxorubicine et cisplatine et l'autre à base de gemcitabine et cisplatine
The efficacy of neoadjuvant chemotherapy before radical cystectomy for individuals with muscle-invasive bladder cancer has been evidenced since the 1990s. Although the clinical benefit of cisplatin-containing regimens is indisputable, establishing the optimal scheme has been a challenge, requiring the evaluation of efficacy, toxicity, and effect on surgical resection. In current clinical practice, the chemotherapeutic regimens most commonly used have not been tested in phase 3 trials in the neoadjuvant setting. Instead, superior efficacy has been inferred from randomised trials in advanced urothelial cancer.
The Lancet Oncology , commentaire, 2022