Evidence map›Paper›PMID 24821883›Full record

Trial reportJournal of clinical oncology : official journal of the American Society of Clinical Oncology2014

Neoadjuvant dose-dense methotrexate, vinblastine, doxorubicin, and cisplatin with pegfilgrastim support in muscle-invasive urothelial cancer: pathologic, radiologic, and biomarker correlates.

Toni K Choueiri, Susanna Jacobus, Joaquim Bellmunt, Angela Qu, Leonard J Appleman, Christopher Tretter, Glenn J Bubley, Edward C Stack, Sabina Signoretti, Meghara Walsh and 9 more

Registry-linked trialOpen access · bronzeAbstract readClinical Trial, Phase IIMulticenter Study
In one paragraph

Trial report in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04047693 (Efficacy and Safety of Neoadjuvant Chemotherapy With Dose Dense MVAC Followed by Radical Surgery in Patients With MIBC and Locally Advanced Urothelial Carcinoma of Bladder), which is not on this map. Cited by 120 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
120citing papers in PubMed, 5 pooled it
24.3field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04047693 phase2unknown statusnot on this mapstarted 2019, after this paper: background citation

Efficacy and Safety of Neoadjuvant Chemotherapy With Dose Dense MVAC Followed by Radical Surgery in Patients With MIBC and Locally Advanced Urothelial Carcinoma of Bladder: Phase II, Single-arm Study

TypeinterventionalSponsorPusan National University Yangsan HospitalRan2019 to 2022Enrolled32ConditionsMuscle Invasive Bladder Cancer, Urothelial Carcinoma, Neoadjuvant ChemotherapyArmsdose dense MVAC with pegylated GCSF
3 · Its place in the literature

Who cites it

120 citing papers in PubMed, 5 syntheses or guidelines pooled it, 278 citations in OpenAlex.

  1. Pooled it
  2. Guideline
  3. NCCN Guidelines Insights: Bladder Cancer, Version 2.2016.Journal of the National Comprehensive Cancer Network : JNCCN · 2016
    Guideline
  4. Pooled it
  5. Pooled it
  6. Phase II Trial of Risk-Enabled Therapy After Neoadjuvant Chemotherapy for Muscle-Invasive Bladder Cancer (RETAIN 1).Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2025
    Trial
  7. Trial
  8. Neoadjuvant Atezolizumab With Gemcitabine and Cisplatin in Patients With Muscle-Invasive Bladder Cancer: A Multicenter, Single-Arm, Phase II Trial.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2022
    Trial
  9. Trial
  10. A Randomized Phase II Study of Coexpression Extrapolation (COXEN) with Neoadjuvant Chemotherapy for Bladder Cancer (SWOG S1314; NCT02177695).Clinical cancer research : an official journal of the American Association for Cancer Research · 2021
    Trial
  11. Trial
  12. Multicenter Prospective Phase II Trial of Neoadjuvant Dose-Dense Gemcitabine Plus Cisplatin in Patients With Muscle-Invasive Bladder Cancer.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2018
    Trial
  13. Trial
  14. Article
  15. Observational
  16. Review
  17. Article
  18. Review
  19. Article
  20. Cancer chemoprevention: signaling pathways and strategic approaches.Signal transduction and targeted therapy · 2025
    Review

60 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

19 authors at 7 institutions in 1 country.

Toni K ChoueiriToni K. Choueiri, Susanna Jacobus, Joaquim Bellmunt, Angela Qu, Edward C. Stack, Sabina Signoretti, Meghara Walsh, Graeme Steele, Michelle Hirsch, Christopher J. Sweeney, Mary-Ellen Taplin, Adam S. Kibel, Katherine M. Krajewski, Philip W. Kantoff, Robert W. Ross, and Jonathan E. Rosenberg, Dana-Farber Cancer Institute and Brigham and Women's Hospital; Christopher Tretter, Lahey Clinic, Burlington; Glenn J. Bubley, Beth Israel Deaconess Medical Center, Boston, MA; Leonard J. Appleman, University of Pittsburgh, Pittsburgh, PA; and Jonathan E. Rosenberg, Memorial Sloan-Kettering Cancer Center, New York, NY. toni_choueiri@dfci.harvard.edu.
Susanna JacobusToni K. Choueiri, Susanna Jacobus, Joaquim Bellmunt, Angela Qu, Edward C. Stack, Sabina Signoretti, Meghara Walsh, Graeme Steele, Michelle Hirsch, Christopher J. Sweeney, Mary-Ellen Taplin, Adam S. Kibel, Katherine M. Krajewski, Philip W. Kantoff, Robert W. Ross, and Jonathan E. Rosenberg, Dana-Farber Cancer Institute and Brigham and Women's Hospital; Christopher Tretter, Lahey Clinic, Burlington; Glenn J. Bubley, Beth Israel Deaconess Medical Center, Boston, MA; Leonard J. Appleman, University of Pittsburgh, Pittsburgh, PA; and Jonathan E. Rosenberg, Memorial Sloan-Kettering Cancer Center, New York, NY.
Joaquim BellmuntToni K. Choueiri, Susanna Jacobus, Joaquim Bellmunt, Angela Qu, Edward C. Stack, Sabina Signoretti, Meghara Walsh, Graeme Steele, Michelle Hirsch, Christopher J. Sweeney, Mary-Ellen Taplin, Adam S. Kibel, Katherine M. Krajewski, Philip W. Kantoff, Robert W. Ross, and Jonathan E. Rosenberg, Dana-Farber Cancer Institute and Brigham and Women's Hospital; Christopher Tretter, Lahey Clinic, Burlington; Glenn J. Bubley, Beth Israel Deaconess Medical Center, Boston, MA; Leonard J. Appleman, University of Pittsburgh, Pittsburgh, PA; and Jonathan E. Rosenberg, Memorial Sloan-Kettering Cancer Center, New York, NY.
Angela QuToni K. Choueiri, Susanna Jacobus, Joaquim Bellmunt, Angela Qu, Edward C. Stack, Sabina Signoretti, Meghara Walsh, Graeme Steele, Michelle Hirsch, Christopher J. Sweeney, Mary-Ellen Taplin, Adam S. Kibel, Katherine M. Krajewski, Philip W. Kantoff, Robert W. Ross, and Jonathan E. Rosenberg, Dana-Farber Cancer Institute and Brigham and Women's Hospital; Christopher Tretter, Lahey Clinic, Burlington; Glenn J. Bubley, Beth Israel Deaconess Medical Center, Boston, MA; Leonard J. Appleman, University of Pittsburgh, Pittsburgh, PA; and Jonathan E. Rosenberg, Memorial Sloan-Kettering Cancer Center, New York, NY.
Leonard J ApplemanToni K. Choueiri, Susanna Jacobus, Joaquim Bellmunt, Angela Qu, Edward C. Stack, Sabina Signoretti, Meghara Walsh, Graeme Steele, Michelle Hirsch, Christopher J. Sweeney, Mary-Ellen Taplin, Adam S. Kibel, Katherine M. Krajewski, Philip W. Kantoff, Robert W. Ross, and Jonathan E. Rosenberg, Dana-Farber Cancer Institute and Brigham and Women's Hospital; Christopher Tretter, Lahey Clinic, Burlington; Glenn J. Bubley, Beth Israel Deaconess Medical Center, Boston, MA; Leonard J. Appleman, University of Pittsburgh, Pittsburgh, PA; and Jonathan E. Rosenberg, Memorial Sloan-Kettering Cancer Center, New York, NY.
Christopher TretterToni K. Choueiri, Susanna Jacobus, Joaquim Bellmunt, Angela Qu, Edward C. Stack, Sabina Signoretti, Meghara Walsh, Graeme Steele, Michelle Hirsch, Christopher J. Sweeney, Mary-Ellen Taplin, Adam S. Kibel, Katherine M. Krajewski, Philip W. Kantoff, Robert W. Ross, and Jonathan E. Rosenberg, Dana-Farber Cancer Institute and Brigham and Women's Hospital; Christopher Tretter, Lahey Clinic, Burlington; Glenn J. Bubley, Beth Israel Deaconess Medical Center, Boston, MA; Leonard J. Appleman, University of Pittsburgh, Pittsburgh, PA; and Jonathan E. Rosenberg, Memorial Sloan-Kettering Cancer Center, New York, NY.
Glenn J BubleyToni K. Choueiri, Susanna Jacobus, Joaquim Bellmunt, Angela Qu, Edward C. Stack, Sabina Signoretti, Meghara Walsh, Graeme Steele, Michelle Hirsch, Christopher J. Sweeney, Mary-Ellen Taplin, Adam S. Kibel, Katherine M. Krajewski, Philip W. Kantoff, Robert W. Ross, and Jonathan E. Rosenberg, Dana-Farber Cancer Institute and Brigham and Women's Hospital; Christopher Tretter, Lahey Clinic, Burlington; Glenn J. Bubley, Beth Israel Deaconess Medical Center, Boston, MA; Leonard J. Appleman, University of Pittsburgh, Pittsburgh, PA; and Jonathan E. Rosenberg, Memorial Sloan-Kettering Cancer Center, New York, NY.
Edward C StackToni K. Choueiri, Susanna Jacobus, Joaquim Bellmunt, Angela Qu, Edward C. Stack, Sabina Signoretti, Meghara Walsh, Graeme Steele, Michelle Hirsch, Christopher J. Sweeney, Mary-Ellen Taplin, Adam S. Kibel, Katherine M. Krajewski, Philip W. Kantoff, Robert W. Ross, and Jonathan E. Rosenberg, Dana-Farber Cancer Institute and Brigham and Women's Hospital; Christopher Tretter, Lahey Clinic, Burlington; Glenn J. Bubley, Beth Israel Deaconess Medical Center, Boston, MA; Leonard J. Appleman, University of Pittsburgh, Pittsburgh, PA; and Jonathan E. Rosenberg, Memorial Sloan-Kettering Cancer Center, New York, NY.
Sabina SignorettiToni K. Choueiri, Susanna Jacobus, Joaquim Bellmunt, Angela Qu, Edward C. Stack, Sabina Signoretti, Meghara Walsh, Graeme Steele, Michelle Hirsch, Christopher J. Sweeney, Mary-Ellen Taplin, Adam S. Kibel, Katherine M. Krajewski, Philip W. Kantoff, Robert W. Ross, and Jonathan E. Rosenberg, Dana-Farber Cancer Institute and Brigham and Women's Hospital; Christopher Tretter, Lahey Clinic, Burlington; Glenn J. Bubley, Beth Israel Deaconess Medical Center, Boston, MA; Leonard J. Appleman, University of Pittsburgh, Pittsburgh, PA; and Jonathan E. Rosenberg, Memorial Sloan-Kettering Cancer Center, New York, NY.
Meghara WalshToni K. Choueiri, Susanna Jacobus, Joaquim Bellmunt, Angela Qu, Edward C. Stack, Sabina Signoretti, Meghara Walsh, Graeme Steele, Michelle Hirsch, Christopher J. Sweeney, Mary-Ellen Taplin, Adam S. Kibel, Katherine M. Krajewski, Philip W. Kantoff, Robert W. Ross, and Jonathan E. Rosenberg, Dana-Farber Cancer Institute and Brigham and Women's Hospital; Christopher Tretter, Lahey Clinic, Burlington; Glenn J. Bubley, Beth Israel Deaconess Medical Center, Boston, MA; Leonard J. Appleman, University of Pittsburgh, Pittsburgh, PA; and Jonathan E. Rosenberg, Memorial Sloan-Kettering Cancer Center, New York, NY.
Graeme SteeleToni K. Choueiri, Susanna Jacobus, Joaquim Bellmunt, Angela Qu, Edward C. Stack, Sabina Signoretti, Meghara Walsh, Graeme Steele, Michelle Hirsch, Christopher J. Sweeney, Mary-Ellen Taplin, Adam S. Kibel, Katherine M. Krajewski, Philip W. Kantoff, Robert W. Ross, and Jonathan E. Rosenberg, Dana-Farber Cancer Institute and Brigham and Women's Hospital; Christopher Tretter, Lahey Clinic, Burlington; Glenn J. Bubley, Beth Israel Deaconess Medical Center, Boston, MA; Leonard J. Appleman, University of Pittsburgh, Pittsburgh, PA; and Jonathan E. Rosenberg, Memorial Sloan-Kettering Cancer Center, New York, NY.
Michelle HirschToni K. Choueiri, Susanna Jacobus, Joaquim Bellmunt, Angela Qu, Edward C. Stack, Sabina Signoretti, Meghara Walsh, Graeme Steele, Michelle Hirsch, Christopher J. Sweeney, Mary-Ellen Taplin, Adam S. Kibel, Katherine M. Krajewski, Philip W. Kantoff, Robert W. Ross, and Jonathan E. Rosenberg, Dana-Farber Cancer Institute and Brigham and Women's Hospital; Christopher Tretter, Lahey Clinic, Burlington; Glenn J. Bubley, Beth Israel Deaconess Medical Center, Boston, MA; Leonard J. Appleman, University of Pittsburgh, Pittsburgh, PA; and Jonathan E. Rosenberg, Memorial Sloan-Kettering Cancer Center, New York, NY.
Christopher J SweeneyToni K. Choueiri, Susanna Jacobus, Joaquim Bellmunt, Angela Qu, Edward C. Stack, Sabina Signoretti, Meghara Walsh, Graeme Steele, Michelle Hirsch, Christopher J. Sweeney, Mary-Ellen Taplin, Adam S. Kibel, Katherine M. Krajewski, Philip W. Kantoff, Robert W. Ross, and Jonathan E. Rosenberg, Dana-Farber Cancer Institute and Brigham and Women's Hospital; Christopher Tretter, Lahey Clinic, Burlington; Glenn J. Bubley, Beth Israel Deaconess Medical Center, Boston, MA; Leonard J. Appleman, University of Pittsburgh, Pittsburgh, PA; and Jonathan E. Rosenberg, Memorial Sloan-Kettering Cancer Center, New York, NY.
Mary-Ellen TaplinToni K. Choueiri, Susanna Jacobus, Joaquim Bellmunt, Angela Qu, Edward C. Stack, Sabina Signoretti, Meghara Walsh, Graeme Steele, Michelle Hirsch, Christopher J. Sweeney, Mary-Ellen Taplin, Adam S. Kibel, Katherine M. Krajewski, Philip W. Kantoff, Robert W. Ross, and Jonathan E. Rosenberg, Dana-Farber Cancer Institute and Brigham and Women's Hospital; Christopher Tretter, Lahey Clinic, Burlington; Glenn J. Bubley, Beth Israel Deaconess Medical Center, Boston, MA; Leonard J. Appleman, University of Pittsburgh, Pittsburgh, PA; and Jonathan E. Rosenberg, Memorial Sloan-Kettering Cancer Center, New York, NY.
Adam S KibelToni K. Choueiri, Susanna Jacobus, Joaquim Bellmunt, Angela Qu, Edward C. Stack, Sabina Signoretti, Meghara Walsh, Graeme Steele, Michelle Hirsch, Christopher J. Sweeney, Mary-Ellen Taplin, Adam S. Kibel, Katherine M. Krajewski, Philip W. Kantoff, Robert W. Ross, and Jonathan E. Rosenberg, Dana-Farber Cancer Institute and Brigham and Women's Hospital; Christopher Tretter, Lahey Clinic, Burlington; Glenn J. Bubley, Beth Israel Deaconess Medical Center, Boston, MA; Leonard J. Appleman, University of Pittsburgh, Pittsburgh, PA; and Jonathan E. Rosenberg, Memorial Sloan-Kettering Cancer Center, New York, NY.
Katherine M KrajewskiToni K. Choueiri, Susanna Jacobus, Joaquim Bellmunt, Angela Qu, Edward C. Stack, Sabina Signoretti, Meghara Walsh, Graeme Steele, Michelle Hirsch, Christopher J. Sweeney, Mary-Ellen Taplin, Adam S. Kibel, Katherine M. Krajewski, Philip W. Kantoff, Robert W. Ross, and Jonathan E. Rosenberg, Dana-Farber Cancer Institute and Brigham and Women's Hospital; Christopher Tretter, Lahey Clinic, Burlington; Glenn J. Bubley, Beth Israel Deaconess Medical Center, Boston, MA; Leonard J. Appleman, University of Pittsburgh, Pittsburgh, PA; and Jonathan E. Rosenberg, Memorial Sloan-Kettering Cancer Center, New York, NY.
Philip W KantoffToni K. Choueiri, Susanna Jacobus, Joaquim Bellmunt, Angela Qu, Edward C. Stack, Sabina Signoretti, Meghara Walsh, Graeme Steele, Michelle Hirsch, Christopher J. Sweeney, Mary-Ellen Taplin, Adam S. Kibel, Katherine M. Krajewski, Philip W. Kantoff, Robert W. Ross, and Jonathan E. Rosenberg, Dana-Farber Cancer Institute and Brigham and Women's Hospital; Christopher Tretter, Lahey Clinic, Burlington; Glenn J. Bubley, Beth Israel Deaconess Medical Center, Boston, MA; Leonard J. Appleman, University of Pittsburgh, Pittsburgh, PA; and Jonathan E. Rosenberg, Memorial Sloan-Kettering Cancer Center, New York, NY.
Robert W RossToni K. Choueiri, Susanna Jacobus, Joaquim Bellmunt, Angela Qu, Edward C. Stack, Sabina Signoretti, Meghara Walsh, Graeme Steele, Michelle Hirsch, Christopher J. Sweeney, Mary-Ellen Taplin, Adam S. Kibel, Katherine M. Krajewski, Philip W. Kantoff, Robert W. Ross, and Jonathan E. Rosenberg, Dana-Farber Cancer Institute and Brigham and Women's Hospital; Christopher Tretter, Lahey Clinic, Burlington; Glenn J. Bubley, Beth Israel Deaconess Medical Center, Boston, MA; Leonard J. Appleman, University of Pittsburgh, Pittsburgh, PA; and Jonathan E. Rosenberg, Memorial Sloan-Kettering Cancer Center, New York, NY.
Jonathan E RosenbergToni K. Choueiri, Susanna Jacobus, Joaquim Bellmunt, Angela Qu, Edward C. Stack, Sabina Signoretti, Meghara Walsh, Graeme Steele, Michelle Hirsch, Christopher J. Sweeney, Mary-Ellen Taplin, Adam S. Kibel, Katherine M. Krajewski, Philip W. Kantoff, Robert W. Ross, and Jonathan E. Rosenberg, Dana-Farber Cancer Institute and Brigham and Women's Hospital; Christopher Tretter, Lahey Clinic, Burlington; Glenn J. Bubley, Beth Israel Deaconess Medical Center, Boston, MA; Leonard J. Appleman, University of Pittsburgh, Pittsburgh, PA; and Jonathan E. Rosenberg, Memorial Sloan-Kettering Cancer Center, New York, NY.
Memorial Sloan Kettering Cancer Center · USBeth Israel Deaconess Medical Center · USBrigham and Women's Hospital · USDana-Farber Brigham Cancer Center · USLahey Hospital and Medical Center · USUniversity of Pittsburgh · USDana-Farber Cancer Institute · US

Funding

X-RAY CRYSTALLOGRAPHYP30CA008748 · NCI · SLOAN-KETTERING INSTITUTE FOR CANCER RES · PI Nicholas D Socci · 1985 to 2026
$347.4M
NCI NIH HHS P30 CA008748
6 · The paper itself

Abstract

purposeIn advanced urothelial cancer, treatment with dose-dense methotrexate, vinblastine, doxorubicin, and cisplatin (ddMVAC) results in a high response rate, less toxicity, and few dosing delays. We explored the efficacy and safety of neoadjuvant ddMVAC with pegfilgrastim support in muscle-invasive urothelial cancer (MIUC). PATIENTS AND

methodsPatients with cT2-cT4, N0-1, M0 MIUC were enrolled. Four cycles of ddMVAC were administered, followed by radical cystectomy. The primary end point was pathologic response (PaR) defined by pathologic downstaging to ≤ pT1N0M0. The study used Simon's optimal two-stage design to evaluate null and alternative hypotheses of PaR rate of 35% versus 55%. Secondary end points included toxicity, disease-free survival (DFS), radiologic response (RaR), and biomarker correlates, including ERCC1.

resultsBetween December 2008 and April 2012, 39 patients (cT2N0, 33%; cT3N0, 18%; cT4N0, 3%; cT2-4N1, 43%; unspecified, 3%) were enrolled. Median follow-up was 2 years. Overall, 49% (80% CI, 38 to 61) achieved PaR of ≤ pT1N0M0, and we concluded this regimen was effective. High-grade (grade ≥ 3) toxicities were observed in 10% of patients, with no neutropenic fevers or treatment-related death. One-year DFS was 89% versus 67% for patients who achieved PaR compared with those who did not (hazard ratio [HR], 2.6; 95% CI, 0.8 to 8.1; P = .08) and 86% versus 62% for patients who achieved RaR compared with those who did not (HR, 4.1; 95% CI, 1.3 to 12.5; P = .009). We found no association between serum tumor markers or ERCC1 expression with response or survival.

conclusionIn patients with MIUC, neoadjuvant ddMVAC was well tolerated and resulted in significant pathologic and radiologic downstaging.

Indexed as

CystectomyAgedAged, 80 and overAntineoplastic Combined Chemotherapy ProtocolsBiomarkers, TumorCarcinoma, Transitional CellChemotherapy, AdjuvantCisplatinDisease-Free SurvivalDNA-Binding ProteinsDoxorubicinDrug Administration ScheduleEndonucleasesFemaleFilgrastimFollow-Up StudiesBiomarkers, TumorCisplatinDNA-Binding ProteinsDoxorubicinEndonucleasesERCC1 protein, humanFilgrastimGranulocyte Colony-Stimulating FactorMethotrexatepegfilgrastimPolyethylene GlycolsProtective AgentsRecombinant ProteinsVinblastine

Identifiers

PMID24821883
PMCPMC7057274
OpenAlexW2164791945

What OpenQuestion holds

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Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.