Neoadjuvant GC with MVAC Have Comparable Efficacy in Bladder Cancer

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In muscle-invasive bladder cancer, gemcitabine plus cisplatin and MVAC were comparable.
In muscle-invasive bladder cancer, gemcitabine plus cisplatin and MVAC were comparable.

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.

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.

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