Neoadjuvant Cabazitaxel Plus Cisplatin in Muscle-Invasive Bladder Cancer
Posted: Thursday, April 29, 2021
According to research from a single-arm phase II trial, presented in Clinical Genitourinary Cancer, a neoadjuvant treatment regimen of cabazitaxel plus cisplatin may be effective and well tolerated in patients with muscle-invasive bladder cancer. Amit Bahl, MD, of the Bristol Cancer Institute in the United Kingdom, and colleagues investigated the safety and efficacy of this combination therapy when administered before definitive treatment.
“The higher [pathologic complete response] rate warrants further evaluation of the cabazitaxel/cisplatin regimen in a larger phase III trial,” noted the study authors. “Combinations of immunotherapy with gemcitabine plus cisplatin (pembrolizumab in ClinicalTrials.gov identifier NCT02365766, nivolumab in NCT03294304, and atezolizumab in NCT02989584) are underway.”
Between July 2012 and August 2017, the study enrolled 26 patients with muscle-invasive bladder cancer but no nodal or metastatic disease. Patients received four 21-day cycles of 15 mg/m2 of cabazitaxel plus 70 mg/m2 of cisplatin on day 1 of each cycle followed by radical cystectomy. Overall, 15 patients (57.7%) achieved an objective response, and 9 patients (34.6%) achieved a pathologic complete response. Among patients achieving an objective response, median progression-free survival and overall survival were not reached, with a median follow-up of 41.5 months. However, for those who did not achieve an objective response, median progression-free survival and overall survival were significantly worse (7.2 months and 16.9 months, respectively).
The majority of adverse events were grade 2 or lower, with 6.7% being grade 3 or 4. A total of six serious treatment-related adverse events occurred. None of the adverse events were categorized as suspected unexpected serious reactions.
Disclosure: The study authors reported no conflicts of interest.