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Accelerated chemotherapy given before surgery benefits patients with muscle-invasive bladder cancer
Date:5/17/2012

CHICAGO, IL (May 16, 2012)For some patients with muscle-invasive bladder cancer, treatment may begin before they undergo cystectomy, or surgical removal of the bladder. They may be advised by oncologists to receive chemotherapy before surgery. A large randomized clinical trial published in 2003 demonstrated a survival benefit for neoadjuvant, or pre-surgical, MVAC (methotrexate, vinblastine, doxorubicin and cisplatin) using a standard dose and schedule. However, in an effort to improve toxicity, standard MVAC has been essentially abandoned in favor of other regimens. All current standard neoadjuvant regimens require 12 weeks of chemotherapy.

Now, final results from a phase II clinical trial at Fox Chase Cancer Centerto be presented at the 2012 American Society of Clinical Oncology Annual Meeting on Saturday, June 2point to a treatment regimen that delivers benefits comparable to those of standard MVAC but without the same time requirement. Preliminary findings from the trial show that when MVAC is administered on an accelerated schedule (six weeks instead of 12), accelerated MVAC (AMVAC) patients experienced similar response rates and lower toxicity.

"Accelerated MVAC is an excellent option in terms of efficiency, quick time to surgery, tolerability, and complete response rate," says Elizabeth Plimack, M.D., a medical oncologist at Fox Chase. "It means less time off work for the patient, and less time elapses between their diagnosis and surgery. We hope that this regimen, which is well tolerated and can be given efficiently and quickly without sacrificing effectiveness, will help improve acceptance of neoadjuvant chemotherapy in the medical oncology and urology community."

Plimack and her colleagues recruited patients with muscle-invasive bladder cancer from Fox Chase and the Kimmel Cancer Center at Thomas Jefferson University in Philadelphia. Patients underwent AMVAC every two weeks for six weeks and had a radical cystectomy with
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Contact: Diana Quattrone
Diana.Quattrone@fccc.edu
215-728-7784
Fox Chase Cancer Center
Source:Eurekalert

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