Patients with muscle-invasive bladder cancer who received neoadjuvant gemcitabine plus cisplatin (GC) and methotrexate, vinblastine, doxorubicin, plus cisplatin (MVAC) achieved comparable pathologic complete response rates, a new study published online early in the journal Cancer has shown.

Although GC has become a neoadjuvant regimen for muscle-invasive bladder cancer, there is a lack of Level I evidence to support its use in this setting.

Therefore, researchers conducted a retrospective study to compare its efficacy with MVAC in this patient population.

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Researchers analyzed data from 212 patients who were treated at 28 international centers. Of those, 146 received GC and 66 were treated with MVAC, the majority of which received dose-dense MVAC. Patients received a median of 3 cycles of neoadjuvant chemotherapy.

Results showed that the pathologic complete response rate was 29% in the MVAC group compared with 31% in the GC group.

RELATED: Adjuvant Chemotherapy Improves Survival in Advanced Nonmetastatic Bladder Cancer

No significant difference was observed in the pathologic complete response rate when adjusted for propensity scores between the two groups (OR = 0.91; 95% CI: 0.48-1.72; P = 0.77).

In an exploratory analysis, researchers found no statistically significant difference in survival between the two cohorts (HR = 0.78; 95% CI: 0.40-1.54; P = 0.48).

The authors conclude that the findings support the use of GC in patients with muscle-invasive bladder cancer.


  1. Galsky MD, Pal SK, Chowdhury S, et al. Comparative effectiveness of gemcitabine plus cisplatin versus methotrexate, vinblastine, doxorubicin, plus cisplatin as neoadjuvant therapy for muscle-invasive bladder cancer. Cancer. 2015. [Epub ahead of print]. doi: 10.1002/cncr.29387.