Cancer Therapy AdvisorNeoadjuvant dd-MVAC Bests Gemcitabine-Cisplatin in Muscle-Invasive Bladder Cancer

How could the use of dd-MVAC in neoadjuvant therapy revolutionize survival outcomes for muscle-invasive bladder cancer patients?

In early June at the ASCO Annual Meeting, new, potentially practice-changing research was presented, which suggests that dose-dense methotrexate, vinblastine, doxorubicin, and cisplatin (dd-MVAC) could significantly improve overall survival (OS) rates for patients with muscle-invasive bladder cancer undergoing neoadjuvant therapy.

Key Points:

• Dd-MVAC enhances OS in comparison to gemcitabine and cisplatin in neoadjuvant therapy for muscle-invasive bladder cancer.
• Data gathered from the phase 3 VESPER trial (NCT01812369) which included 500 patients; 437 underwent neoadjuvant chemotherapy.
• Five-year OS rates were significantly higher for dd-MVAC recipients in the neoadjuvant setting, 66% versus 57% for gemcitabine-cisplatin recipients.

Additional Points:

• Dd-MVAC did not significantly impact the OS in the total study population.
• In the neoadjuvant setting, dd-MVAC significantly reduced the risk of death by 30%.
• No significant effect on death risk was observed in the adjuvant setting with dd-MVAC.

Conclusion:

• The use of dd-MVAC in the neoadjuvant setting offers potential for increased survival rates for muscle-invasive bladder cancer patients, highlighting a potential shift in therapeutic strategies.

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