ESMO guideline for management of patients with bladder cancer

Written By : Medha Baranwal |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2022-01-07T09:15:00+05:30 | Updated On 7 Jan 2022 12:13 PM IST

Delhi: A recent guideline by the European Society for Medical Oncology (ESMO), published in the Annals of Oncology, provides key recommendations for the diagnosis, staging, and management of bladder cancer. The guideline also contains recommendations for personalized medicine.

The recommendations, compiled by a multinational and multidisciplinary group of experts led by T. Powles from the Queen Mary University of London, London, UK, are based on the latest available scientific data and the authors' expert opinions.

Urothelial carcinoma (UC), also described as bladder cancer, is the 10th most common cancer type worldwide, with an estimated 549 000 new cases and 200 000 deaths in 2018.

Key recommendations

Non-muscle-invasive bladder cancer

Follow a risk-stratified approach with transurethral resection of a bladder tumor resection and intravesical chemotherapy or Bacillus Calmette-Guerin in intermediate- and high-risk patients.

Muscle-invasive bladder cancer

Radical cystectomy with standard pelvic lymph node dissection is recommended.
Organ preservation therapy with radiotherapy is an option for patients seeking an alternative to radical cystectomy and those who are medically unfit for surgery.
3-4 cycles of cisplatin-based neoadjuvant chemotherapy should be given for MIBC.

Advanced or metastatic bladder cancer

Cisplatin-based chemotherapy is recommended in patients fit to tolerate chemotherapy followed by maintenance avelumab.
Gemcitabine/carboplatin followed by maintenance avelumab is recommended in patients not eligible for cisplatin-based therapy.
Atezolizumab or pembrolizumab should be considered for patients with programmed death-ligand 1 biomarker-positive tumors who are not eligible for cisplatin-based chemotherapy.

Relapsed advanced/metastatic urothelial carcinoma

Pembrolizumab is recommended.
Enfortumab-vedotin is recommended for patients who relapsed on chemotherapy and immunotherapy-relapsed disease.

Upper tract urothelial carcinoma

Offer kidney-sparing management to low-risk patients and radical nephroureterectomy with bladder cuff excision to high-risk patients.

"These recommendations are updated continuously in order to include results of the latest clinical trials," wrote the authors.

Reference:

"BLADDER CANCER: ESMO CLINICAL PRACTICE GUIDELINE FOR DIAGNOSIS, TREATMENT AND FOLLOW-UP†," is published in the journal Annals of Oncology.

DOI: https://www.annalsofoncology.org/article/S0923-7534(21)04827-4/fulltext

Annals of Oncologybladder cancer

Source : Annals of Oncology

Medha Baranwal

MSc. Biotechnology

Medha Baranwal joined Medical Dialogues as an Editor in 2018 for Speciality Medical Dialogues. She covers several medical specialties including Cardiac Sciences, Dentistry, Diabetes and Endo, Diagnostics, ENT, Gastroenterology, Neurosciences, and Radiology. She has completed her Bachelors in Biomedical Sciences from DU and then pursued Masters in Biotechnology from Amity University. She has a working experience of 5 years in the field of medical research writing, scientific writing, content writing, and content management. She can be contacted at editorial@medicaldialogues.in. Contact no. 011-43720751

Dr. Kamal Kant Kohli

Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751