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Would you offer adjuvant chemotherapy for platinum eligible patients with pT2pN0 urothelial carcinoma of bladder or UTUC who did not receive neoadjuvant chemotherapy?

If so, what regimen would you use? Would a carboplatin-based regimen be acceptable or only cisplatin?
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Do you offer adjuvant chemotherapy for patients with pT2N0 bladder cancer who did not receive neoadjuvant chemotherapy?

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3 Answers
Mednet Member
Mednet MemberInvited Expert
Medical Oncology · AdventHealth Cancer Institute
Answered on · Updated on

I agree with both of my colleagues that adjuvant cisplatin-based combination chemotherapy is unproven for pT2N0 bladder cancer, although the POUT upper tract urothelial carcinoma phase III trial (which demonstrated significantly improved DFS) did recruit >=pT2N0 patients to evaluate adjuvant gemcita...

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Mednet Member
Mednet Member
Medical Oncology · Rutgers Cancer Institute of New Jersey
Answered on

In my practice, I'd offer both, but I'd recommend trial if it is available

If there is no trial:

I would say "yes" for upper tract urothelial carcinoma (UTUC). I routinely discuss and recommend adjuvant therapy based on the POUT study It showed the benefit of adjuvant therapy with platinum and gemcit...

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Mednet Member
Mednet MemberInvited Expert
Medical Oncology · University of North Carolina at Chapel Hill
Answered on

In the setting of urothelial carcinoma of the upper tract including the renal pelvis and/or ureter, the POUT trial (The Lancet 2020), a phase 3 randomized controlled trial evaluating adjuvant chemotherapy with 4 cycles of either gemcitabine with cisplatin or carboplatin as compared to surveillance i...

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