If both look good, those patients can be observed with bladder evaluations every 3 months or so, without surgery or radiation. The rest of the patients, depending on how much cancer is left in the bladder on evaluation, can choose to receive either chemotherapy or surgery. This trial will be open at Thomas Jefferson University Hospital, Johns Hopkins Medicine, and is currently open at Fox Chase Cancer Center.
What clinical implications could this study have?
Having a bladder removal alters one's quality of life; many people do well with it and continue to thrive after cystectomy or surgery to remove the bladder. But if it can be avoided, then certainly we want to do that. For a subset of patients, we think it can be done safely and we want to prove that.
What do you hope community oncologists took away from your discussion?
The takeaway should be that chemotherapy in the neoadjuvant setting is still the standard of care. Most patients can get it; it is safe and effective. We need to continue to optimize how we use old tools, even cisplatin, which is decades old.