Chemotherapy Archives

Role of DNA Repair Mutations in Sensitivity to Cisplatin-based Chemotherapy

by Gopalkumar Iyer, MD | Mar 2025

Gopalkumar Iyer, MD, explores the role of genomic alterations in predicting response to neoadjuvant chemotherapy for muscle-invasive bladder cancer.

Implications of EV 302 How do We Sequence Treatment in the Future

by Shilpa Gupta, MD | Mar 2025

Shilpa Gupta, MD, explores the evolving treatment paradigm in metastatic urothelial carcinoma following the EV-302 trial.

PCa Commentary | Volume 198 – February 2025

by Edward Weber, MD | Feb 2025

Pluvicto was approved in March 2022 for therapy in men with heavily pretreated castration resistant metastatic prostate cancer, and since then, it has become a frequently prescribed life-prolonging treatment. Sartor et al., NEJM 2021, reported that the median imaging-based progression-free survival for 177Lu PSMA was 8.7 months vs. 3.4 for ADT alone, and the median overall survival was 15.3 months vs.11.3 for ADT. Quality of life was similar. Pluvicto is administered via a short IV infusion every 6 weeks for 4-6 cycles.

Updates in Radiotherapy for Bladder Cancer

by Daniel A. Hamstra, MD, PhD, FASTRO, FASCO | Dec 2024

Daniel A. Hamstra, MD, PhD, FASTRO, FASCO, explores advances in bladder cancer therapy, focusing on trimodality bladder preservation. In this 21-minute presentation, he compares the North American approach, which requires strict criteria for bladder preservation, including thorough TURBT and an absence of extensive CIS, to a more inclusive UK approach, which tolerates certain conditions such as CIS and hydronephrosis and utilizes non-platinum-based chemotherapy.

Hamstra shares a significant UK phase III trial that illustrates the effectiveness of adding chemotherapy to radiation, enhancing local control and survival, and reducing the need for cystectomy. A multi-institutional study comparing this approach with radical cystectomy indicates comparable metastasis-free and overall survival rates, suggesting trimodality therapy as a viable alternative to surgery.

Hamstra notes that neoadjuvant chemotherapy is emerging as beneficial in bladder preservation, with data supporting its utility across different cancers when combined with radiation. For node-positive bladder cancer, combined chemoradiotherapy (chemoRT) appears as effective as surgery in appropriately selected patients.

Newer immunotherapies and non-platinum regimens continue to expand options, while evidence supports chemoRT as an alternative to radical surgery, especially for patients prioritizing quality of life and organ preservation.

Cardiovascular Side Effects of Advanced Disease Therapies

by William K. Oh, MD | Nov 2023

William K. Oh, MD, details the common therapies used in advanced prostate cancer, including androgen deprivation therapy (ADT), novel hormonal agents like abiraterone and enzalutamide, and chemotherapies such as docetaxel. He emphasizes that while these treatments are effective in controlling cancer progression and improving survival, they have significant cardiovascular risks.
The lecture presents evidence from multiple studies demonstrating that ADT is associated with an increased risk of cardiovascular events, including myocardial infarction, stroke, and sudden cardiac death. Dr. Oh discusses the underlying mechanisms, such as metabolic changes, increased insulin resistance, and adverse lipid profiles induced by hormone deprivation.
Dr. Oh emphasizes the importance of a multidisciplinary approach in managing patients undergoing these treatments. He advocates for regular cardiovascular monitoring, risk assessment, and the involvement of cardiologists in the care team to mitigate these risks.

Chemotherapy For Prostate Cancer

by David Utz | Aug 2019

GRU’s content partner, Prostatepedia, has announced the topic for their August 2019 interview series: addressing patient fears regarding chemotherapy.

Controversies in Non-Muscle Invasive Bladder Cancer

by Siamak Daneshmand, MD | Oct 2018

Siamak Daneshmand, MD, reports on recent controversies in treatment for non-muscle invasive bladder cancer (NMIBC) regarding chemotherapy options for reducing post-transurethral resection (TUR) recurrences and active surveillance for low-grade patients, as well as alternatives to cystectomy in high-grade patients.

Neoadjuvant/ Adjuvant Chemotherapy—Are We Ready to Accept Neoadjuvant as the Gold Standard?

by Seth P. Lerner, MD, FACS | Mar 2018

Seth P. Lerner, MD, argues for adopting neoadjuvant chemotherapy as the standard of care for metastatic bladder cancer patients. Dr. Lerner believes the urological community needs to define a better range of risk-stratification and more accurate diagnostic methods in order to do this. He discusses current developments in prognostic biomarkers and expression subtypes that he believes will make these necessary improvements possible.