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In randomized trials, patients with muscle-invasive bladder cancer who achieved P0 status (no detectable disease) after radical cystectomy had better outcomes with neoadjuvant cisplatin-based multiagent chemotherapy. However, utilization of this therapy is poor in the US due to concerns about toxicity and delayed time to cystectomy.
Now, investigators have conducted a phase II, multicenter study to evaluate the use of three cycles of accelerated neoadjuvant MVAC (methotrexate, vinblastine, doxorubicin, cisplatin) administered over 6 weeks with white blood cell growth factor support followed by cystectomy. Patients had muscle-invasive bladder cancer (cT2-T4a) and could have a solitary pelvic lymph node measuring <2 cm. During 2.5 years, 44 pa…