Chemotherapeutic and targeted biological agents for metastatic bladder cancer: a comprehensive review. [Review]
Chemotherapeutic and targeted biological agents for metastatic bladder cancer: a comprehensive review. [Review]
- 2014
The American Cancer Society estimates that 73510 new cases of bladder cancer will be diagnosed and 15000 deaths will result this year. The paper summarizes the clinical evidence for the use of platinum-based, non-platinum-based and new targeted biological agents, while reporting the future directions in the treatment of metastatic bladder cancer. For cisplatin-base regimens, the combination of methotrexate, vinblastine, doxorubicin and cisplatin (M-VAC) has been the mainstream treatment for both advanced and metastatic bladder cancers. It showed significant improvement in the complete response rate and overall survival time in comparison with single-agent cisplatin. For cisplatin-ineligible patients, namely patients with renal impairment, symptomatic cardiac disease and poor performance status, alternative therapies consisting of paclitaxel, gemcitabine and carboplatin were shown to be of benefit. Pemetrexed and vinflunine have also shown effectiveness, with small but demonstrable overall survival benefits. Gemcitabine-based doublet therapies (combined with paclitaxel, docetaxel, irinotecan, oxaliplatin or epirubicin) have all been shown to be effective and well-tolerated. Several new targeted therapies, such as gefetinib, sorafenib and lapatinib, have received attention in recent years; however, their effectiveness as single agents in a relapse setting have not been optimal and more studies are warranted.Copyright � 2014 The Japanese Urological Association.
English
0919-8172
*Antineoplastic Combined Chemotherapy Protocols/tu [Therapeutic Use]
*Urinary Bladder Neoplasms/dt [Drug Therapy]
*Urinary Bladder Neoplasms/sc [Secondary]
Carboplatin/tu [Therapeutic Use]
Cisplatin/tu [Therapeutic Use]
Doxorubicin/tu [Therapeutic Use]
Humans
Methotrexate/tu [Therapeutic Use]
Vinblastine/tu [Therapeutic Use]
Washington Cancer Institute
Journal Article
Review
The American Cancer Society estimates that 73510 new cases of bladder cancer will be diagnosed and 15000 deaths will result this year. The paper summarizes the clinical evidence for the use of platinum-based, non-platinum-based and new targeted biological agents, while reporting the future directions in the treatment of metastatic bladder cancer. For cisplatin-base regimens, the combination of methotrexate, vinblastine, doxorubicin and cisplatin (M-VAC) has been the mainstream treatment for both advanced and metastatic bladder cancers. It showed significant improvement in the complete response rate and overall survival time in comparison with single-agent cisplatin. For cisplatin-ineligible patients, namely patients with renal impairment, symptomatic cardiac disease and poor performance status, alternative therapies consisting of paclitaxel, gemcitabine and carboplatin were shown to be of benefit. Pemetrexed and vinflunine have also shown effectiveness, with small but demonstrable overall survival benefits. Gemcitabine-based doublet therapies (combined with paclitaxel, docetaxel, irinotecan, oxaliplatin or epirubicin) have all been shown to be effective and well-tolerated. Several new targeted therapies, such as gefetinib, sorafenib and lapatinib, have received attention in recent years; however, their effectiveness as single agents in a relapse setting have not been optimal and more studies are warranted.Copyright � 2014 The Japanese Urological Association.
English
0919-8172
*Antineoplastic Combined Chemotherapy Protocols/tu [Therapeutic Use]
*Urinary Bladder Neoplasms/dt [Drug Therapy]
*Urinary Bladder Neoplasms/sc [Secondary]
Carboplatin/tu [Therapeutic Use]
Cisplatin/tu [Therapeutic Use]
Doxorubicin/tu [Therapeutic Use]
Humans
Methotrexate/tu [Therapeutic Use]
Vinblastine/tu [Therapeutic Use]
Washington Cancer Institute
Journal Article
Review