Brock O’Neil, MD, assistant professor, Division of Urology, University of Utah School of Medicine, Huntsman Cancer Institute, discusses adjuvant therapy for patients with bladder cancer.
There were several trials that were attempted but subsequently closed due to poor enrollment, says O’Neil. The problem, he says, is that cystectomy is a very morbid procedure. All the trials have a window in which patients need to be enrolled into adjuvant therapy if they are going to do it. However, there are a lot of challenges with enrollment following post-surgical complications.
Urologists believe that physicians can identify those patients who are the most likely to benefit from neoadjuvant therapy and surgery, and then select those who are not likely to benefit from neoadjuvant chemotherapy. If physicians are still worried about those patients who did not receive neoadjuvant chemotherapy, they can receive adjuvant chemotherapy after surgery. That is the direction the field will move in, says O’Neil.