Treatment MIBC | Schemes | References | |
---|---|---|---|
A. cT3, cT4a (negative nodes) | |||
Neoadjuvant CT | ○ MVAC | 6, 7, 8, 9 | |
○ HD-MAV | |||
Adjuvant CT | ○ GC | 2, 13*, 14, 15 | |
○ PGC | |||
B. Metastatic disease | |||
1st line | ‘Fit’ for Cisplatin (GFR ≥ 60 mL/min; PS 0–1) | ○ GC | 21, 22, 23 |
○ MVAC | |||
○ PGC | |||
‘Unfit’ for Cisplatin (GFR < 60 mL/ min; PS 2) | ○ Combinations based in Carboplatin (CaG/M-CaV) | 24, 25, 26, 27 | |
○ Monotherapy (P, G, Vinflunine) | |||
2nd line | ‘Fit’ | ○ Vinflunine | 35 |
‘Unfit’ | ○ Clinical trial |