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Advances in Urology
Volume 2013 (2013), Article ID 317190, 6 pages
http://dx.doi.org/10.1155/2013/317190
Research Article

Pathologic Response Rates of Gemcitabine/Cisplatin versus Methotrexate/Vinblastine/Adriamycin/Cisplatin Neoadjuvant Chemotherapy for Muscle Invasive Urothelial Bladder Cancer

1Department of Urology, University of Washington School of Medicine, Seattle, WA 98195, USA
2Department of Urology, University of Washington Medical Center, Health Sciences Building, 1959 NE Pacific, BB-1115, Box 356510, Seattle, WA 98195, USA
3Division of Medical Oncology, Department of Medicine, University of Washington School of Medicine, Seattle, WA 98195, USA
4Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA
5Group Health Permanente, Seattle, WA 98109, USA
6Huntsman Cancer Institute, Division of Medical Oncology, The University of Utah, Salt Lake City, UT 84112, USA
7Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA

Received 5 August 2013; Accepted 24 October 2013

Academic Editor: Miroslav L. Djordjevic

Copyright © 2013 Franklin C. Lee et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives. To compare pathologic outcomes after treatment with gemcitabine and cisplatin (GC) versus methotrexate, vinblastine, adriamycin, and cisplatin (MVAC) in the neoadjuvant setting. Methods. Data was retrospectively collected on 178 patients with T2-T4 bladder cancer who underwent radical cystectomy between 2003 and 2011. Outcomes of interest included those with complete response (pT0) and any response (≤pT1). Odds ratios were calculated using multivariate logistic regression. Results. Compared to those who did not receive neoadjuvant chemotherapy, there were more patients with complete response (28% versus 9%, OR 3.11 (95% CI: 1.45–6.64), ) and any response (52% versus 25%, OR 3.23 (95% CI: 1.21–8.64), ). Seventy-two patients received GC ( ) or MVAC ( ). CR was achieved in 29% and 22% of GC and MVAC patients, respectively (multivariate OR 0.39, 95% CI 0.10–1.58). Any response (≤pT1) was achieved in 56% of GC and 45% of MVAC patients (multivariate OR 0.45, 95% CI 0.12–1.71). Conclusions. We observed similar pathologic response rates for GC and MVAC neoadjuvant chemotherapy in this cohort of patients with muscle invasive urothelial cancer (MIBC). Our findings support the use of GC as an alternative regimen in the neoadjuvant setting.