Controversies in the treatment of invasive urothelial carcinoma: a case report and review of the literature

BMC Urology

Table 1 Summary of the current chemotherapeutic options in muscle invasive bladder carcinoma

Treatment MIBC		Schemes	References
A. cT3, cT4a (negative nodes)
Neoadjuvant CT		○ MVAC	6, 7, 8, 9
Neoadjuvant CT		○ HD-MAV	6, 7, 8, 9
Adjuvant CT		○ GC	2, 13*, 14, 15
Adjuvant CT		○ PGC	2, 13*, 14, 15
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
	‘Unfit’ for Cisplatin (GFR < 60 mL/ min; PS 2)	○ Monotherapy (P, G, Vinflunine)	24, 25, 26, 27
2nd line	‘Fit’	○ Vinflunine	35
2nd line	‘Unfit’	○ Clinical trial	35

(*) No significant differences reported; A: Adriamycin, C: cisplatin, Ca: carboplatin, G: gemcitabine, M: methotrexate, P: paclitaxel, V: vinblastine, CT: chemotherapy.

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