Bladder Cancer Neoadjuvant Chemotherapy on the Rise

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The proportion of patients who received neoadjuvant chemotherapy for muscle-invasive bladder cancer prior to cystectomy rose from 4% to 27% of patients from 1994 to 2013.
The proportion of patients who received neoadjuvant chemotherapy for muscle-invasive bladder cancer prior to cystectomy rose from 4% to 27% of patients from 1994 to 2013.

Use of neoadjuvant chemotherapy (NACT) for bladder cancer has been on the rise, according to a Canadian study.

Findings from the study, which included 5582 patients who underwent cystectomy for muscle-invasive bladder cancer (MIBC), suggest that increased uptake of NACT has been driven by greater preoperative referral to medical oncologists and a greater propensity of medical oncologists to use the treatment in referred patients, investigators reported online ahead of print in Urologic Oncology.

Using the population-based Ontario Cancer Registry to identify all patients who underwent cystectomy from 1994 to 2013, Christopher M. Booth, MD, and colleagues at Queens College in Kingston, Ontario, found that NACT use increased significantly from 4% of MIBC cases during 1994–2008 to 19% during 2009–2013.

The rates increased from 12% in 2009 to 27% in 2013.

The rate of adjuvant chemotherapy (ACT) use did not change significantly between 1994–2008 and 2009–2013 (19% vs 20%), according to the investigators. The use of either NACT or ACT increased significantly from 23% during 1994–2008 to 35% during 2009–2013.

Results also showed that preoperative referral rates to medical oncologists increased significantly from 11% during 1994–2008 to 32% during 2009–2013.

Further, the proportion of patients who ultimately received NACT increased significantly from 32% during 1994–1998 to 54% in 2009–2013.

Reference

Booth CM, Karim S, Brennan K, et al. Perioperative chemotherapy for bladder cancer in the general population: Are practice patterns finally changing? Urol Oncol 2017; published online ahead of print.

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