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Thomas Flaig, MD


ASCO 2023: How Many Cycles of Neoadjuvant Chemotherapy Is Enough for Muscle-Invasive Bladder Cancer?

By: Sarah Lynch
Posted: Wednesday, June 14, 2023

A group of researchers from Temple University Health System and Fox Chase Cancer Center, Philadelphia, studied the differences in recurrence and survival rates of patients with muscle-invasive bladder cancer who were treated with neoadjuvant cisplatin-based chemotherapy prior to radical cystectomy. The investigators compared patients who had received fewer than three cycles of chemotherapy with patients who had received three or more. They found that early cessation of chemotherapy had significant implications on outcomes in these patients. Their findings were presented during the 2023 American Society for Clinical Oncology (ASCO) Annual Meeting (Abstract 4586).

“If patients are able to tolerate the three cycles of neoadjuvant chemotherapy, clinicians should encourage and try to support patients to receive all three cycles,” said lead author Anumita Chakraborty, MD, in a Fox Chase press release. “Patients who receive less than three cycles would need to be followed very closely after treatment to monitor for recurrence because they have a significantly higher recurrence rate.”

The current standard of care for neoadjuvant chemotherapy for muscle-invasive bladder cancer is at least three cycles of neoadjuvant cisplatin-based chemotherapy prior to radical cystectomy. However, some patients stop chemotherapy early because of toxicity-related side effects.

The researchers reviewed the records of 195 patients, 30 of whom had received fewer than three cycles. They compared the pathologic response, cancer recurrence, and overall survival rates of the two patient groups.

The research team discovered that patients who completed fewer than three cycles of chemotherapy were more likely to have worse outcomes than patients receiving the standard of care. These patients were also more likely to experience cancer recurrence, and they were 40% less likely to survive 5 years after treatment. The team confirmed that although this study revealed statistics with clinical implications for both patients and physicians, future studies are still needed to solidify these findings.

Disclosure: Dr. Chakraborty reported no conflicts of interest. For full disclosures of the other study authors, visit

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