Cancer therapy selection, dosing, administration, and the management of related adverse events can be a complex process that should be handled by an experienced healthcare team. Clinicians must choose and verify treatment options based on the individual patient; drug dose modifications and supportive care interventions should be administered accordingly.
The cancer treatment regimens below may include both U. These regimens are only provided to supplement the latest treatment strategies. These Guidelines are a work in progress that may be refined as often as new significant data becomes available. The NCCN makes no warranties of any kind whatsoever regarding their content, bladder cancer and radiation therapy, use, or application and disclaims any responsibility for their application or use in any way.
Perioperative Chemotherapy Neoadjuvant or Adjuvant 1,a. All recommendations are Category 2A unless otherwise indicated. May be extended for up to a total of 14 consecutive days. Days 1, 8, and Leucovorin 15mg orally every 6 hours for 4 doses after methotrexate on day 8.
Bladder cancer and radiation therapy dose compliance bladder cancer and radiation therapy be achieved with fewer delays in dosing bladder cancer and radiation therapy the day schedule. Although safer, the relative efficacy of the cisplatin-containing combination administered with such modifications remains undefined.
Days 1 and 8: Day 1 every 3 weeks: Days 2 and 4: Patients without these adverse prognostic factors have the greatest benefit from chemotherapy. The impact of these factors in relation to immune checkpoint inhibition is not fully defined, but they remain poor prognostic indicators in general.
Pembrolizumab Category 1 Paclitaxel or docetaxel 25, Days 1, 2, 3, 15, 16, and Day 1—3, 8—10, 15— Day 1 of radiotherapy: Week 1 fractions 1—5 and Week 4 fractions 16—20 of radiotherapy: Low-dose gemcitabine Categor y 2 B 34, Accessed February 23, Neoadjuvant chemotherapy plus cystectomy compared with cystectomy alone for locally advanced bladder cancer. N Engl J Med. Gemcitabine and cisplatin versus methotrexate, vinblastine, doxorubicin, and cisplatin in advanced or metastatic bladder cancer: International phase III trial assessing neoadjuvant cisplatin, methotrexate, and vinblastine chemotherapy for muscle-invasive bladder cancer: Neoadjuvant chemotherapy in invasive bladder cancer: Adjuvant chemotherapy in invasive bladder cancer: Three-week versus four-week schedule of cisplatin and gemcitabine: Atezolizumab as first-line treatment in cisplatin-ineligible patients with locally advanced and metastatic urothelial carcinoma: Pembrolizumab as first-line therapy in cisplatin-ineligible advanced urothelial cancer: Phase II study of single-agent gemcitabine in previously untreated patients with metastatic urothelial cancer.
Gemcitabine and paclitaxel every 2 weeks in patients with previously untreated urothelial carcinoma, bladder cancer and radiation therapy. A phase II clinical trial of sequential neoadjuvant chemotherapy with ifosfamide, doxorubicin, and gemcitabine, bladder cancer and radiation therapy, followed by cisplatin, gemcitabine, and ifosfamide in locally advanced urothelial cancer: Pembrolizumab as second-line therapy for advanced urothelial carcinoma.
Atezolizumab in patients with locally advanced and metastatic urothelial carcinoma who have progressed following treatment with platinum-based chemotherapy: Nivolumab in metastatic urothelial carcinoma after platinum therapy CheckMate Updated efficacy and tolerability of durvalumab in allergy and lessons advanced or metastatic urothelial carcinoma. Avelumab, an anti—programmed death-ligand 1 antibody, in patients with refractory metastatic urothelial carcinoma: Avelumab in patients with metastatic urothelial carcinoma: Efficacy of weekly paclitaxel treatment as a single agent chemotherapy following first-line cisplatin treatment in urothelial bladder cancer.
Phase II bladder cancer and radiation therapy of docetaxel in patients with advanced or metastatic transitional-cell carcinoma. Phase II study of pemetrexed for second-line treatment of transitional cell cancer of the urothelium.
Nanoparticle albumin-bound paclitaxel for second-line treatment of metastatic urothelial carcinoma: Eastern Cooperative Oncology Group phase II trial of ifosfamide in the treatment depakote and testosterone previously treated advanced urothelial carcinoma. Transurethral surgery and twice-daily radiation plus paclitaxel-cisplatin or fluorouracil-cisplatin with selective bladder preservation and adjuvant chemotherapy for patients with muscle invasive bladder cancer RTOG Long-term outcomes of selective bladder preservation by combined-modality therapy for invasive bladder cancer: Radiotherapy with or without chemotherapy in muscle-invasive bladder cancer, bladder cancer and radiation therapy.
Improved local control of invasive bladder cancer by concurrent cisplatin and preoperative or definitive radiation. Combined-modality therapy with gemcitabine and radiotherapy as a bladder preservation strategy: Phase II study of conformal hypofractionated radiotherapy with concurrent gemcitabine in muscle-invasive bladder cancer.
Patients at VA facilities with high-risk early-stage bladder cancer tend to have cystoscopic surveillance at frequencies similar to those with low-risk disease. Treatment with NAC did not transform the prevailing subtype in bladder cancer — instead, shifts in cancer subtype were attributed to tumor plasticity.
Do We Have Any Evidence? Repeat every 2 weeks for 3—4 cycles. Repeat every 4 weeks for 4 cycles. Repeat every 3 weeks for 3 cycles.
Repeat every 4 weeks for a maximum of 6 cycles, bladder cancer and radiation therapy. Repeat cycle every 15 days. Atezolizumab mg Atkins diet and blood pressure infusion over 60 antidote onion and garlic allergies every 3 weeks.
Pembrolizumab mg every 3 weeks. Useful Under Certain Circumstances. Atezolizumab mg IV winfusion over 60 minutes every 3 weeks. Preferred Regimens Doublet Preferred. Prostate And Other Male Cancers. Cancer Therapy Advisor Daily Update. Cancer Therapy Advisor Weekly Highlights.