Of the 33 patients who underwent all three rounds of AMVAC, for whom final data is available, 13 (39.1 percent) had a pathologic complete response at the time of surgery. Pathologic complete response, a common prognostic indicator for bladder cancer, indicates that the pathology evaluation of the resected bladder revealed no cancerous cells. The tumors of an additional three patients (9.1 percent) were downstaged during the pathology evaluation, suggesting that AMVAC had some effect in those patients as well. Final data will be presented at the meeting.
The AMVAC data suggest an accelerated course of chemotherapy before surgery confers comparable benefit as standard, 12-week MVACbut without the high toxicity associated with standard treatment.
The National Cancer Institute estimates that nearly 75,000 people will be diagnosed with bladder cancer in 2012, and nearly 15,000 will die from the disease. Patients who are diagnosed with bladder cancer that has spread into the muscle layer of the bladder wall have significantly lower survival rates than those patients whose tumors are confined to the inside lining of the organ. Existing treatment for invasive bladder cancer is unlikely to cure the disease, though it may prolong the time before the disease progresses or symptoms reappear.
"As medical oncologists, we are able to offer cancer-specific therapy to many of our bladder cancer patients, but unfortunately at this time there are few situations where chemotherapy helps achieve cure," says Plimack. "Neoadjuvant chemotherapy has been shown to provide incremental benefit in what I think is the most important endpoint, which is bladder cancer specific survival at five years. Most patients who are cancer free at five years do not experience a recurrence of their cancer. Our goal is to improve the chance of cure for patients going to cystectomy."
At Fox Chase, Plimack specializes in researc
|Contact: Diana Quattrone|
Fox Chase Cancer Center