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Second-line therapy in bladder cancer
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Bachner, Mark and De Santis, Maria (2009) Second-line therapy in bladder cancer. Current Opinion in Urology, Volume 19 (Number 5). pp. 533-539. doi:10.1097/MOU.0b013e32832eb473 ISSN 0963-0643.
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Official URL: http://dx.doi.org/10.1097/MOU.0b013e32832eb473
Abstract
PURPOSE OF REVIEW:
To review new developments in second-line treatment for transitional cell carcinoma of the urinary bladder focusing on advances and findings within the last year.
RECENT FINDINGS:
So far no standard therapy has been established for pretreated patients with transitional cell carcinoma. Prognostic and predictive factors for response and outcome in pretreated patients have been studied retrospectively and will help to identify those who might benefit from intensive therapy and those who would rather improve their quality of life with best supportive care. Single-agent chemotherapy in this setting provided low response rates, short progression-free and overall survival. Vinflunine, a novel vinca-alkaloid, and best supportive care had a modest, but still significant benefit at a very moderate toxicity rate in a randomized phase III trial. As for second-line combination chemotherapy, response rates as well as potential toxicities are higher and the progression-free survival and overall survival benefits are still poorly understood. New chemotherapeutics and approaches like metronomic chemotherapy and novel agents are under investigation.
SUMMARY:
With vinflunine there is reasonable hope for a new standard chemotherapy in second-line management of transitional cell carcinoma. However, due to the reported results with single agents and combination chemotherapy, treatment within clinical trials is still the best choice in patients progressing after first-line chemotherapy.
Item Type: | Journal Article | ||||
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Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Cancer Research Unit Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Journal or Publication Title: | Current Opinion in Urology | ||||
Publisher: | Lippincott Williams & Wilkins, Ltd. | ||||
ISSN: | 0963-0643 | ||||
Official Date: | September 2009 | ||||
Dates: |
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Volume: | Volume 19 | ||||
Number: | Number 5 | ||||
Page Range: | pp. 533-539 | ||||
DOI: | 10.1097/MOU.0b013e32832eb473 | ||||
Status: | Peer Reviewed | ||||
Publication Status: | Published | ||||
Access rights to Published version: | Restricted or Subscription Access |
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