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2025_LM_Innovations_Urologie.pdf
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Abstract
(en) [Strategies for developing a personalized care pathway for muscle-invasive bladder cancer] The standard treatment for non-metastatic muscle-invasive bladder cancer is neoadjuvant systemic chemotherapy followed by cystectomy or radiochemotherapy, regardless of the extent of tumor response. Recent studies have questioned the relevance of local treatment in cases of complete clinical response after systemic therapy. De-escalation strategies are limited by the poor correlation between clinical assessment of tumor response and the final pathology results from radical cystectomy specimens. Therefore, there is significant interest in developing and validating a multimodal signature to improve the prediction of response to systemic treatment using several available tools: cystoscopy with biopsies, multiparametric bladder MRI, quantification of circulating and urinary tumor DNA, and evaluation of urinary biomarkers. A more accurate assessment of tumor response to initial systemic treatment could help inform patients when choosing between standard treatment and a risk-adapted strategy: bladder-sparing procedures (clinical surveillance or intravesical treatments) for responders and immediate escalation of systemic therapy without local treatment for non-responders.
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Van Damme, J., Tombal, B., Gizzi, M., Van Nieuwenhove, S., Pasoglou, V., Grisay, G., & Seront, E. (2025). Innovations 2024 en Urologie. Louvain médical, 144(2), 122-124. https://hdl.handle.net/2078.5/271440 (Original work published 2025)