Predictive Value of Prior Non–muscle-invasive Bladder Cancer for the Effectiveness of Neoadjuvant Chemotherapy in Localized Muscle-invasive Bladder Cancer: A Real-world Analysis of the BLADRAC Cohort
Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND AND OBJECTIVE: It remains currently unknown whether the effectiveness of neoadjuvant chemotherapy (NAC) before radical cystectomy (RC) for muscle-invasive bladder cancer (MIBC) is the same in patients with or without prior non-muscle invasive bladder cancer (NMIBC). This study aims to perform a real-world analysis of the predictive value of prior NMIBC for the effectiveness of NAC in patients undergoing RC for MIBC. METHODS: We included 2378 patients from the BLADRAC cohort who received RC with (n = 870; 37%) or without (n = 1508; 63%) NAC for primary (n = 1825; 77%) or secondary (n = 553; 23%) MIBC at 15 French centers from 2001 to 2023. Multivariable logistic regression models were fitted to identify the predictors of NAC delivery as well as those of pathological complete (pCR = [y]pT0N0) and pathological objective (pOR ≤[y]pT1N0) responses, while we assessed the predictors of recurrence-free (RFS), cancer-specific (CSS), and overall (OS) survival using multivariable Cox regression models. The heterogeneity of treatment effect of NAC according to the occurrence of prior NMIBC was determined further by testing the interaction terms between the occurrence of prior NMIBC and the effect of NAC within the models evaluating pathological and survival outcomes. KEY FINDINGS AND LIMITATIONS: > 0.05). The study is limited by its retrospective design. CONCLUSIONS AND CLINICAL IMPLICATIONS: Our real-world data suggest that the occurrence of prior NMIBC could limit the access to NAC, while not predicting its effectiveness in patients treated with RC for localized MIBC.
Source: European Urology Oncology
Authors: Elisabeth Grobet-Jeandin, Elliott Diamant, Pierre-Etienne Gabriel, Alexandre De Olivera, Théo Harber, Marc Colombel, Paul Hanquiez, Vera Chatain, Dimitri Vordos, Igor Duquesne, Mihnea Bogdan Borz, Gregory Verhoest, Anne Mauger De Varennes, Louis Surlemont, Marion Ghenassia, Alexandra Masson-Lecomte, Arthur Peyrottes, Cédric Lebacle, Peter Beniac, Priscilla Léon, Stéphane Larré, Fayek Taha, Gautier Marcq, Aleksandra Szostek, Benjamin Pradere, Giorgio Calleris, Evanguelos Xylinas, Yves Allory, Anne-Sophie Bajeot, Doriane Prost, François Audenet, Constance Thibault, Morgan Rouprêt, Mathieu Roumiguié, Thomas Seisen
Institutions: Sorbonne Université, Pitié-Salpêtrière Hospital, Onco-Urologie Prédictive, Université Paris-Est Créteil, Hôpitaux Universitaires Henri-Mondor, Centre Hospitalier Universitaire de Toulouse, Hospices Civils de Lyon, Hôpital Lyon Sud, Université Paris Cité, Hôpital Cochin, Assistance Publique – Hôpitaux de Paris, Université de Rennes, Centre Hospitalier Universitaire de Rouen, Hôpital Saint-Louis, Bicêtre Hospital, Clinique Pasteur, Centre Hospitalier Universitaire de Reims, Centre Hospitalier Universitaire de Lille, Hôpital Claude Huriez, University of Turin, Hôpital Bichat-Claude-Bernard, Centre National de la Recherche Scientifique, Biologie cellulaire et Cancer, Institut Curie, Hôpital Paris Saint-Joseph, Hôpital Européen Georges-Pompidou
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,790
OpenAlex ID: W4417535614