Gemcitabine and cisplatin neoadjuvant chemotherapy for muscle-invasive urothelial carcinoma: Predicting response and assessing outcomes

Nilay M. Gandhi, Alexander Baras, Enrico Munari, Sheila Faraj, Leonardo O. Reis, Jen-Jane Liu, Max Kates, Mohammad Obaidul Hoque, David Berman, Noah M. Hahn, Mario Eisenberger, George J. Netto, Mark P. Schoenberg, Trinity J. Bivalacqua

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Purpose: To evaluate gemcitabine-cisplatin (GC) neoadjuvant cisplatin-based chemotherapy (NAC) for pathologic response (pR) and cancer-specific outcomes following radical cystectomy (RC) for muscle-invasive bladder cancer and identify clinical parameters associated with pR. Materials and methods: We studied 150 consecutive cases of muscle-invasive bladder cancer that received GC NAC followed by open RC (2000-2013). A cohort of 121 patients treated by RC alone was used for comparison. Pathologic response and cancer-specific survival (CSS) were compared. We created the Johns Hopkins Hospital Dose Index to characterize chemotherapeutic dosing regimens and accurately assess sufficient neoadjuvant dosing regarding patient tolerance. Results: No significant difference was noted in 5-year CSS between GC NAC (58%) and non-NAC cohorts (61%). The median follow-up was 19.6 months (GC NAC) and 106.5 months (non-NAC). Patients with residual non-muscle-invasive disease after GC NAC exhibit similar 5-year CSS relative to patients with no residual carcinoma (P = 0.99). NAC pR (≤pT1) demonstrated improved 5-year CSS rates (90.6% vs. 27.1%, P

Original languageEnglish (US)
Pages (from-to)204e1-204e7
JournalUrologic Oncology: Seminars and Original Investigations
Volume33
Issue number5
DOIs
StatePublished - May 1 2015
Externally publishedYes

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gemcitabine
Cisplatin
Carcinoma
Drug Therapy
Muscles
Cystectomy
Neoplasms
Urinary Bladder Neoplasms
Survival

Keywords

  • Bladder cancer
  • Gemcitabine-cisplatin
  • Neoadjuvant chemotherapy
  • Pathologic response
  • Urothelial carcinoma

ASJC Scopus subject areas

  • Oncology
  • Urology

Cite this

Gemcitabine and cisplatin neoadjuvant chemotherapy for muscle-invasive urothelial carcinoma : Predicting response and assessing outcomes. / Gandhi, Nilay M.; Baras, Alexander; Munari, Enrico; Faraj, Sheila; Reis, Leonardo O.; Liu, Jen-Jane; Kates, Max; Hoque, Mohammad Obaidul; Berman, David; Hahn, Noah M.; Eisenberger, Mario; Netto, George J.; Schoenberg, Mark P.; Bivalacqua, Trinity J.

In: Urologic Oncology: Seminars and Original Investigations, Vol. 33, No. 5, 01.05.2015, p. 204e1-204e7.

Research output: Contribution to journalArticle

Gandhi, NM, Baras, A, Munari, E, Faraj, S, Reis, LO, Liu, J-J, Kates, M, Hoque, MO, Berman, D, Hahn, NM, Eisenberger, M, Netto, GJ, Schoenberg, MP & Bivalacqua, TJ 2015, 'Gemcitabine and cisplatin neoadjuvant chemotherapy for muscle-invasive urothelial carcinoma: Predicting response and assessing outcomes', Urologic Oncology: Seminars and Original Investigations, vol. 33, no. 5, pp. 204e1-204e7. https://doi.org/10.1016/j.urolonc.2015.02.011
Gandhi, Nilay M. ; Baras, Alexander ; Munari, Enrico ; Faraj, Sheila ; Reis, Leonardo O. ; Liu, Jen-Jane ; Kates, Max ; Hoque, Mohammad Obaidul ; Berman, David ; Hahn, Noah M. ; Eisenberger, Mario ; Netto, George J. ; Schoenberg, Mark P. ; Bivalacqua, Trinity J. / Gemcitabine and cisplatin neoadjuvant chemotherapy for muscle-invasive urothelial carcinoma : Predicting response and assessing outcomes. In: Urologic Oncology: Seminars and Original Investigations. 2015 ; Vol. 33, No. 5. pp. 204e1-204e7.
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AU - Faraj, Sheila

AU - Reis, Leonardo O.

AU - Liu, Jen-Jane

AU - Kates, Max

AU - Hoque, Mohammad Obaidul

AU - Berman, David

AU - Hahn, Noah M.

AU - Eisenberger, Mario

AU - Netto, George J.

AU - Schoenberg, Mark P.

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