Dr. O'Neil on Standard of Care in Muscle-Invasive Bladder Cancer

Brock O’Neil, MD, assistant professor, Division of Urology, University of Utah School of Medicine, Huntsman Cancer Institute, discusses the current standard of care in muscle-invasive bladder cancer (MIBC).

Currently, patients with MIBC who are undergoing a cystectomy receive neoadjuvant treatment with cisplatin-based chemotherapy. Unlike many other related tumor types, MIBC hasn’t seen an update in treatment options in around 20 years. O’Neil says urologists generally haven’t administered neoadjuvant chemotherapy as much as they should, but it’s been getting better in recent years. Another limitation is that not every patient can tolerate neoadjuvant chemotherapy. A lot of patients with bladder cancer develop renal insufficiency, rendering them ineligible to receive cisplatin.

O’Neil stresses that it’s a much inferior approach to give patients carboplatin-based chemotherapy if they cannot receive cisplatin. He is hopeful that new biomarkers will soon emerge that will depict what patients will benefit from neoadjuvant chemotherapy.