دورية أكاديمية
SEOM clinical guideline for treatment of muscle-invasive and metastatic urothelial bladder cancer (2018)
| العنوان: | SEOM clinical guideline for treatment of muscle-invasive and metastatic urothelial bladder cancer (2018) |
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| المؤلفون: | González Del Alba, A., De Velasco, G., Lainez, N., Maroto, P., Morales-Barrera, R., Muñoz-Langa, J., Pérez-Valderrama, B., Basterretxea, L., Caballero, C., Vázquez Estévez, Sergio |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | Clinical Trials as Topic, Cystectomy, Humans, Neoplasm Invasiveness, Combined Modality Therapy, Prognosis, pronóstico, tratamiento combinado, ensayos clínicos como asunto, humanos, cistectomía, invasividad neoplásica, HULA |
| الوصف: | The goal of this article is to provide recommendations about the management of muscle-invasive (MIBC) and metastatic bladder cancer. New molecular subtypes of MIBC are associated with specific clinical-pathological characteristics. Radical cystectomy and lymph node dissection are the gold standard for treatment and neoadjuvant chemotherapy with a cisplatin-based combination should be recommended in fit patients. The role of adjuvant chemotherapy in MIBC remains controversial; its use must be considered in patients with high-risk who are able to tolerate a cisplatin-based regimen, and have not received neoadjuvant chemotherapy. Bladder-preserving approaches are reasonable alternatives to cystectomy in selected patients for whom cystectomy is not contemplated either for clinical or personal reasons. Cisplatin-based combination chemotherapy is the standard first-line protocol for metastatic disease. In the case of unfit patients, carboplatin-gemcitabine should be considered the preferred first-line chemotherapy treatment option, while pembrolizumab and atezolizumab can be contemplated for individuals with high PD-L1 expression. In cases of progression after platinum-based therapy, PD-1/PD-L1 inhibitors are standard alternatives. Vinflunine is another option when anti-PD-1/PD-L1 therapy is not possible. There are no data from randomized clinical trials regarding moving on to immuno-oncology agents. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| تدمد: | 1699-048X |
| العلاقة: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6339669/pdf/12094_2018_Article_2001.pdfTest; http://hdl.handle.net/20.500.11940/16086Test; 35033 |
| DOI: | 10.1007/s12094-018-02001-x |
| الإتاحة: | https://doi.org/20.500.11940/16086Test https://doi.org/10.1007/s12094-018-02001-xTest https://hdl.handle.net/20.500.11940/16086Test https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6339669/pdf/12094_2018_Article_2001.pdfTest |
| حقوق: | Atribución 4.0 Internacional ; http://creativecommons.org/licenses/by/4.0Test/ ; openAccess |
| رقم الانضمام: | edsbas.92DA7992 |
| قاعدة البيانات: | BASE |
| تدمد: | 1699048X |
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| DOI: | 10.1007/s12094-018-02001-x |