HealthDay News — For patients with muscle-invasive bladder cancer, transurethral resection and combination treatment with gemcitabine, cisplatin, plus nivolumab with bladder sparing is feasible in selected patients, according to a study presented at the annual meeting of the American Society of Clinical Oncology.

For the study, Matt D Galsky, MD, from the Tisch Cancer Institute at the Icahn School of Medicine at Mount Sinai in New York City, and colleagues enrolled 76 patients with cT2-T4aN0M0 urothelial bladder cancer. Patients received four cycles of gemcitabine, cisplatin, plus nivolumab and 64 completed post-cycle 4 clinical restaging. Those achieving clinical complete response (cCR) were eligible to proceed without cystectomy and receive nivolumab followed by surveillance.

The researchers found that 31 patients (48%) achieved a cCR and were followed for a median of 13.7 months. One cCR patient opted to undergo cystectomy immediately. Overall, 100% of those with cCR and 87.7% without cCR were alive at one year; 81.2% and 11%, respectively, were alive with bladder intact; and 100% and 79.5%, respectively, were alive and metastasis-free. Local recurrence occurred in 8 of 31 cCR patients and 6 underwent cystectomy.


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“One-year bladder intact survival is possible though the durability of responses, and role of genomic biomarkers in management algorithms requires longer follow-up,” the authors write.

Several authors disclosed financial ties to the biopharmaceutical industry.

Abstract

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