Adjuvant Chemotherapy Benefit Observed in Patients With Advanced Bladder Cancer

Brain C. Baumann, MD, assistant professor of radiation oncology, Department of Radiation Oncology, Washington University School of Medicine St. Louis, explains the rationale for the study of adjuvant chemotherapy plus radiation versus radiation alone in patients with locally advanced bladder cancer.

There is significant controversy surrounding the idea of adjuvant chemotherapy in bladder cancer, say Baumann. This contention is because clinical trials have shown that neoadjuvant chemotherapy improves overall survival (OS), whereas clinical trials evaluating adjuvant chemotherapy have failed to recruit and the benefits observed have been inconsistent. However, meta-analyses and retrospective studies have shown a survival benefit, according to Baumann.

The investigators of the study set out to answer the question of whether adjuvant chemotherapy can improve OS. The findings showed a statistically significant improvement in disease-free survival (14%) with the addition of chemotherapy to radiation in the adjuvant setting. Investigators also observed a statistically significant increase in OS (20%), at 2 years, Baumann concludes.