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http://dx.doi.org/10.1056/NEJMc2415733 | DOI Listing |
Eur Urol Open Sci
September 2025
Urology Department, CHU de Québec-Université Laval, Quebec City, QC, Canada.
Background And Objective: Immune checkpoint inhibitors (ICIs), alone or with platinum-based chemotherapy, have increasingly been studied as neoadjuvant therapy for muscle-invasive bladder cancer (BC). We sought to evaluate the current evidence about neoadjuvant immunotherapy for BC.
Methods: In this systematic review, conducted in October 2024, only prospective studies on neoadjuvant immunotherapy for BC were included.
Cancer
August 2025
Genitourinary Malignancies Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA.
Looking back at 2024, the authors highlight the top five clinical advances in bladder cancer (urothelial carcinoma), from: (1) novel drug-delivery mechanisms in intravesical therapy for nonmuscle-invasive bladder cancer and muscle-invasive bladder cancer (MIBC); (2) immune checkpoint inhibition (ICI) as adjuvant and (3) perioperative therapy in MIBC; (4) circulating tumor DNA as a biomarker in MIBC; to (5) a new standard of care in first-line metastatic urothelial carcinoma. TAR-200 is a new intravesical drug-delivery system that enables controlled release of gemcitabine but may be used with other anticancer drugs to treat nonmuscle-invasive bladder cancer and MIBC. Two phase 3 studies of adjuvant ICI (nivolumab and pembrolizumab) have both reported a doubling of disease-free survival in patients with high-risk MIBC receiving therapy.
View Article and Find Full Text PDFCancer Treat Rev
August 2025
Department of Medicine, Division of Hematology-Oncology, Massachusetts General Hospital, Boston, USA; Harvard Medical School, Boston, MA, USA. Electronic address:
Background: The integration of immunotherapy (IO) with perioperative chemotherapy represents an advance in locally advanced, resectable gastroesophageal cancers. However, randomized controlled trials (RCTs) have yielded discordant findings with respect to event-free survival (EFS) and overall survival (OS), particularly when differing chemotherapy backbones and IO agents are employed. Understanding the sources and implications of these discrepancies is essential for optimizing treatment strategies.
View Article and Find Full Text PDFTher Adv Med Oncol
July 2025
Department of Pharmacy, Fujian Medical University Union Hospital, No. 29 Xinquan Road, Fuzhou 350001, Fujian Province, China.
Background: The management of muscle-invasive bladder cancer (MIBC) remains challenging. The phase III NIAGARA trial showed that adding durvalumab to neoadjuvant chemotherapy significantly enhances event-free and overall survival for MIBC patients. However, due to the high cost of durvalumab, assessing its cost-effectiveness is crucial.
View Article and Find Full Text PDFUrol Oncol
July 2025
Department of Urology, University of Florida, Jacksonville, FL. Electronic address:
Introduction: Recent Phase III trials using immunotherapy agents in perioperative setting for muscle-invasive bladder cancer (MIBC) have reshaped treatment paradigms. Traditional hazard ratios, while statistically robust, may mask modest absolute survival gains, complicating informed decision-making for clinicians and patients alike. This study aims to utilize restricted mean survival time (RMST) analysis to provide more intuitive interpretations of survival benefits and facilitate development of a framework for comparing efficacy, toxicity, and costs across three pivotal trials.
View Article and Find Full Text PDF