Dr. Stanley Yap on Sequential Therapy for Muscle-Invasive Bladder Cancer

Stanley Yap, MD, assistant professor, urologic oncology, UC Davis Comprehensive Cancer Center, discusses sequential therapy after neoadjuvant chemotherapy for muscle-invasive bladder cancer.

The current standard of care for muscle-invasive bladder cancer is to give neoadjuvant chemotherapy followed by radical cystectomy. However, this is associated with a fair amount of morbidly, says Yap.

Yap and his team investigated the idea of sequential therapy to reduce unnecessary radical cystectomy. In his study, patients who had a pathological response following chemotherapy were offered surveillance, with radical cystectomy only after reoccurrence. This group of patients was followed for 10 years, explains Yap.

While some patient did extremely well, and never required a radical cystectomy, there was also a group of patients that faired poorly and did eventually receive a radical cystectomy. Because this study was inclusive, radical cystectomy should remain the standard of care for now, says Yap.