Skip survey header

BLADDR2019 - Case 01

Thank You!

Your case challenge

View case
You answered: B
You answered: B
A) Cisplatin based chemotherapy - B) Immunotherapy within a trial
 

What would Maria De Santis do?

Pauline is a 65 year-old otherwise healthy lady, non-smoker, with muscle invasive bladder cancer. Her work-up shows no hydronephrosis and no metastases. She is definitely fit for cisplatin and her life expectancy without the bladder cancer is at least another 20 years. Many might argue that her prognosis is good and she might not benefit from neoadjuvant therapy. The multidisciplinary team, however, recommended cisplatin/gemcitabine chemotherapy followed by cystectomy or chemo-radiotherapy of the bladder as the definitive treatment options. With neoadjuvant chemotherapy pathological complete response (pCR) can be achieved in 30-40% of patients which is strongly associated with long term overall survival.

At the ASCO GU 2019 meeting, data of PURE-1 and ABACUS showed impressive results with pembrolizumab and atezolizumab, respectively. The pCR rates were at least as good as with chemotherapy and a biomarker program showed that patients could be significantly enriched for pCR. The community is wondering if in the future immunotherapy will replace chemotherapy in cisplatin fit and unfit patients and maybe bladder preservation will become more common with immuno-oncological agents only.

I look forward seeing you at BLADDR on 25-26 October in Paris to discuss this case and similar ones face-to-face.
 
 


What would Maria De Santis do?
Pauline is a 65 year-old otherwise healthy lady, non-smoker, with muscle invasive bladder cancer. Her work-up shows no hydronephrosis and no metastases. She is definitely fit for cisplatin and her life expectancy without the bladder cancer is at least another 20 years. Many might argue that her prognosis is good and she might not benefit from neoadjuvant therapy. The multidisciplinary team, however, recommended cisplatin/gemcitabine chemotherapy followed by cystectomy or chemo-radiotherapy of the bladder as the definitive treatment options. With neoadjuvant chemotherapy pathological complete response (pCR) can be achieved in 30-40% of patients which is strongly associated with long term overall survival.

At the ASCO GU 2019 meeting, data of PURE-1 and ABACUS showed impressive results with pembrolizumab and atezolizumab, respectively. The pCR rates were at least as good as with chemotherapy and a biomarker program showed that patients could be significantly enriched for pCR. The community is wondering if in the future immunotherapy will replace chemotherapy in cisplatin fit and unfit patients and maybe bladder preservation will become more common with immuno-oncological agents only.

I look forward seeing you at BLADDR on 25-26 October in Paris to discuss this case and similar ones face-to-face.
 

Do you have an interesting case of your own?

Up to 3 case reports will be selected by the scientific committee for discussion in the official programme of BLADDR 2019.
 

Submit your case
 

Join us at BLADDR 2019 to get a full update on bladder cancer and discuss with faculty and peers how 2019 highlights will impact your daily practice.


Reserve your seat