Bladder Cancer Treatment (Professional) (cont.)
IN THIS ARTICLE
Recurrent Bladder Cancer
The prognosis for any patient with progressive or recurrent invasive bladder cancer is generally poor. Management of recurrence depends on prior therapy, sites of recurrence, and individual patient considerations. Treatment of new superficial or locally invasive tumors that develop in the setting of previous conservative therapy for superficial bladder neoplasia has been discussed earlier in this summary. Recurrent or progressive disease in distant sites or after definitive local therapy has an extremely poor prognosis, and clinical trials should be considered whenever possible.
In patients with recurrent transitional cell carcinoma, combination chemotherapy has produced high response rates with occasional complete responses seen.[1,2] Results from a randomized trial that compared M-VAC (methotrexate, vinblastine, doxorubicin, and cisplatin) with single-agent cisplatin in advanced bladder cancer show a significant advantage with M-VAC in both response rate and median survival. The overall response rate with M-VAC in this cooperative group trial was 39%. Other chemotherapy agents that have shown activity in metastatic bladder cancer include: paclitaxel, ifosfamide, gallium nitrate, gemcitabine, and pemetrexed. Ifosfamide, gallium, and pemetrexed have shown limited activity in patients previously treated with cisplatin.[4,5,6,7,8,9,10,11]
Current Clinical Trials
Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with recurrent bladder cancer. The list of clinical trials can be further narrowed by location, drug, intervention, and other criteria.
General information about clinical trials is also available from the NCI Web site.
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