Trimodality Therapy for Muscle-Invasive Bladder Cancer: Recent Advances and Unanswered Questions

Curr Oncol Rep. 2020 Feb 1;22(2):14. doi: 10.1007/s11912-020-0880-5.

Abstract

Purpose of review: Bladder-sparing trimodality therapy (TMT) has become an accepted alternative to cystectomy for selected muscle invasive bladder cancer (MIBC) patients unfit for cystectomy or opting for bladder preservation. This review will summarize recent advances in TMT for MIBC.

Recent findings: A growing body of literature has emerged which supports the use of TMT. However, its delivery is yet to be standardized. The role of chemotherapy and predictive biomarkers remain to be elucidated. Novel bladder-sparing approaches, drug combinations including immunotherapy and targeted therapies are under investigation in clinical trials, with the goal of ultimately enhancing survival and quality of life outcomes. Recent advances in TMT have made bladder preservation possible for MIBC patients seeking an alternative local therapy to cystectomy. With careful patient selection, TMT offers comparable survival outcomes to cystectomy, and improved quality of life as patients are able to successfully retain their bladder.

Keywords: Chemoradiation; Muscle-invasive bladder cancer; Trimodality therapy.

Publication types

  • Review

MeSH terms

  • Aftercare
  • Antineoplastic Agents / therapeutic use*
  • Chemoradiotherapy, Adjuvant / methods*
  • Combined Modality Therapy / methods
  • Cystectomy / methods*
  • Humans
  • Muscle, Smooth / pathology
  • Neoplasm Invasiveness
  • Organ Sparing Treatments / methods*
  • Salvage Therapy
  • Urinary Bladder / drug effects
  • Urinary Bladder / surgery
  • Urinary Bladder Neoplasms / diagnosis
  • Urinary Bladder Neoplasms / pathology*
  • Urinary Bladder Neoplasms / therapy*

Substances

  • Antineoplastic Agents