Neoadjuvant Immunotherapy: The Next Gold Standard Before Radical Surgery for Urothelial Cancer
Cisplatin-based chemotherapy followed by radical cystectomy with bilateral pelvic lymph-node dissection is the current standard for cT2–4a N0 M0 urothelial bladder cancer. Immune checkpoint inhibitors have recently been tested in the neoadjuvant setting with promising pathological and survival resul...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2021-08-01
|
| Series: | European Urology Open Science |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666168321001038 |
| _version_ | 1830083489998831616 |
|---|---|
| author | Daniele Raggi Marco Moschini Andrea Necchi |
| author_facet | Daniele Raggi Marco Moschini Andrea Necchi |
| author_sort | Daniele Raggi |
| collection | DOAJ |
| description | Cisplatin-based chemotherapy followed by radical cystectomy with bilateral pelvic lymph-node dissection is the current standard for cT2–4a N0 M0 urothelial bladder cancer. Immune checkpoint inhibitors have recently been tested in the neoadjuvant setting with promising pathological and survival results and a better safety profile. Excellent pathological responses have been observed, especially in cases with higher clinical T stage and PD-L1 expression, in addition to patients with selected gene signatures. In biomarker-selected patients, this manageable approach has the potential to become a new treatment option in the near future. Patient summary: For patients with bladder cancer invading the bladder wall muscle, platinum-based chemotherapy has been the standard treatment. Increasing evidence suggests that an alternative first treatment for this disease could be immunotherapy. Novel biomarkers and further studies are needed to support this approach before it can be used in everyday clinical practice. |
| first_indexed | 2024-12-14T16:22:26Z |
| format | Article |
| id | doaj.art-998f78d310a940aab298d223837d62fe |
| institution | Directory Open Access Journal |
| issn | 2666-1683 |
| language | English |
| last_indexed | 2024-12-14T16:22:26Z |
| publishDate | 2021-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | European Urology Open Science |
| spelling | doaj.art-998f78d310a940aab298d223837d62fe2022-12-21T22:54:46ZengElsevierEuropean Urology Open Science2666-16832021-08-01303436Neoadjuvant Immunotherapy: The Next Gold Standard Before Radical Surgery for Urothelial CancerDaniele Raggi0Marco Moschini1Andrea Necchi2Medical Oncology Department, IRCCS Ospedale San Raffaele, Milan, Italy; Corresponding author. Medical Oncology Department, IRCCS Ospedale San Raffaele, via Olgettina 66, 20132, Milan, Italy. Tel. +39 02 26435789.Department of Urology, Luzerner Kantonsspital, Luzern, SwitzerlandMedical Oncology Department, IRCCS Ospedale San Raffaele, Milan, Italy; Vita-Salute San Raffaele University, Milan, ItalyCisplatin-based chemotherapy followed by radical cystectomy with bilateral pelvic lymph-node dissection is the current standard for cT2–4a N0 M0 urothelial bladder cancer. Immune checkpoint inhibitors have recently been tested in the neoadjuvant setting with promising pathological and survival results and a better safety profile. Excellent pathological responses have been observed, especially in cases with higher clinical T stage and PD-L1 expression, in addition to patients with selected gene signatures. In biomarker-selected patients, this manageable approach has the potential to become a new treatment option in the near future. Patient summary: For patients with bladder cancer invading the bladder wall muscle, platinum-based chemotherapy has been the standard treatment. Increasing evidence suggests that an alternative first treatment for this disease could be immunotherapy. Novel biomarkers and further studies are needed to support this approach before it can be used in everyday clinical practice.http://www.sciencedirect.com/science/article/pii/S2666168321001038Urothelial cancerBladder cancerImmune checkpoint inhibitorsNeoadjuvant treatmentImmune biomarkers |
| spellingShingle | Daniele Raggi Marco Moschini Andrea Necchi Neoadjuvant Immunotherapy: The Next Gold Standard Before Radical Surgery for Urothelial Cancer European Urology Open Science Urothelial cancer Bladder cancer Immune checkpoint inhibitors Neoadjuvant treatment Immune biomarkers |
| title | Neoadjuvant Immunotherapy: The Next Gold Standard Before Radical Surgery for Urothelial Cancer |
| title_full | Neoadjuvant Immunotherapy: The Next Gold Standard Before Radical Surgery for Urothelial Cancer |
| title_fullStr | Neoadjuvant Immunotherapy: The Next Gold Standard Before Radical Surgery for Urothelial Cancer |
| title_full_unstemmed | Neoadjuvant Immunotherapy: The Next Gold Standard Before Radical Surgery for Urothelial Cancer |
| title_short | Neoadjuvant Immunotherapy: The Next Gold Standard Before Radical Surgery for Urothelial Cancer |
| title_sort | neoadjuvant immunotherapy the next gold standard before radical surgery for urothelial cancer |
| topic | Urothelial cancer Bladder cancer Immune checkpoint inhibitors Neoadjuvant treatment Immune biomarkers |
| url | http://www.sciencedirect.com/science/article/pii/S2666168321001038 |
| work_keys_str_mv | AT danieleraggi neoadjuvantimmunotherapythenextgoldstandardbeforeradicalsurgeryforurothelialcancer AT marcomoschini neoadjuvantimmunotherapythenextgoldstandardbeforeradicalsurgeryforurothelialcancer AT andreanecchi neoadjuvantimmunotherapythenextgoldstandardbeforeradicalsurgeryforurothelialcancer |