Fast Five Quiz: Management of Metastatic Bladder Cancer

For medically fit patients with metastatic bladder cancer, cisplatin-based combination chemotherapy is the standard of care for first-line treatment. The most common systemic regimens include methotrexate, vinblastine, doxorubicin, and cisplatin (MVAC), either classic or dose-dense MVAC regimens, and doublet therapy with cisplatin and gemcitabine. With cisplatin-based combination chemotherapy, the median progression-free survival is 7 months and median overall survival is 15 months. Although bladder cancer is chemotherapy-sensitive, the risk for recurrence is estimated to be up to 61% the first year and up to 78% by year 5.

Compared with single-agent cisplatin therapy, MVAC has demonstrated improved overall response rates, median progression-free survival, and median overall survival, according to Loehrer Sr and colleagues.

The antibody-drug conjugate enfortumab vedotin combined with the checkpoint inhibitor pembrolizumab has shown positive results in a clinical trial among patients with metastatic bladder cancer. Its promising results are predicted to lead to an accelerated approval for this drug regimen as a first-line treatment for people with metastatic bladder cancer who cannot receive cisplatin-based chemotherapy.

Intravesical chemotherapy may be an option for early-stage localized bladder cancers.

Radical cystectomy may be an option for localized muscle-invasive bladder cancer after neoadjuvant chemotherapy.

Learn more about metastatic bladder cancer management.

Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.

Cite this: Kyle A. Richards. Fast Five Quiz: Management of Metastatic Bladder Cancer - Medscape - Jan 30, 2023.

Commenting is limited to medical professionals. To comment please Log-in.

Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.

My Alerts