Amirali Salmasi, MD, presented “Point-Counterpoint: Neoadjuvant Chemotherapy Prior to Cystectomy (Pro)” during the 29th Annual Perspectives in Urology: Point-Counterpoint, on November 18, 2021, in Coronado Island, San Diego, California.
How to cite: Salmasi, Amirali. “Point-Counterpoint: Neoadjuvant Chemotherapy Prior to Cystectomy (Pro).” November 18, 2021. Accessed May 2022. https://grandroundsinurology.com/point-counterpoint-neoadjuvant-chemotherapy-prior-to-cystectomy-pro/
Point-Counterpoint: Neoadjuvant Chemotherapy Prior to Cystectomy (Pro)
Taking the pro side in a point-counterpoint debate, Amirali Salmasi, MD, Assistant Professor of Urology at the University of California, San Diego, argues that neoadjuvant chemotherapy (NAC) should be offered to any “fit” patient with invasive bladder cancer before radical cystectomy (RC). After noting that survival outcomes for invasive bladder cancer after cystectomy are not great in general, Dr. Salmasi considers decades of trial data on the addition of NAC to RC. He looks at the SWOG-8710 trial, two Nordic trials, the BA06 30894 trial, a trial of ddMVAC, and more, all of which indicate that NAC improves outcomes significantly. Dr. Salmasi also notes that these trials did find that NAC increased perioperative risks. He then considers the potential role of adjuvant chemotherapy, observing that the limited data available suggest that NAC is superior to adjuvant treatment. Dr. Salmasi concludes with a brief discussion of how urologists and oncologists should optimize the use of NAC by researching therapy combinations, duration, patient selection, and biomarkers.
About the 29th Annual Perspectives in Urology: Point Counterpoint conference:
Presented by Program Chair and Grand Rounds in Urology Editor-in-Chief E. David Crawford, MD, this conference brought together leading experts in urology, medical oncology, and radiation oncology to discuss and debate the latest topics in genitourinary cancers, primarily prostate cancer and bladder cancer. This interactive conference offered topical lectures, pro/con debates, interesting-case presentations, interactive panel discussions, and interactive audience and faculty networking.