Evidence map›Paper›PMID 27053504›Full record

SynthesisThe oncologist2016

Neoadjuvant Chemotherapy for Muscle-Invasive Bladder Cancer: A Systematic Review and Two-Step Meta-Analysis.

Ming Yin, Monika Joshi, Richard P Meijer, Michael Glantz, Sheldon Holder, Harold A Harvey, Matthew Kaag, Elisabeth E Fransen van de Putte, Simon Horenblas, Joseph J Drabick

4 registry-linked trialsOpen access · bronzeAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in The oncologist, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 4 registered trials, which are not on this map. Cited by 231 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
231citing papers in PubMed, 10 pooled it
24.2field-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
NCT04588168 naunknown statusnot on this mapstarted 2018, after this paper: background citation

Multi-parameter Magnetic Resonance Imaging for Early Evaluation of the Efficacy of Neoadjuvant Chemotherapy With Modified GC Regimen for Urothelial Carcinoma

TypeinterventionalSponsorThe First Affiliated Hospital with Nanjing Medical UniversityRan2018 to 2026Enrolled100ConditionsBladder CancerArmsChemotherapy, Immediate Multiparametric MRI, Cystectomy and Lymphadenectomy, conventional Multiparametric MRI, Baseline Multiparametric MRI
NCT06727214 not yet recruitingnot on this mapstarted 2025, after this paper: background citation

Survival Benefit of Neoadjuvant Systemic Chemotherapy in Muscle Invasive Bladder Cancer and Factors Affecting Its Response - Retrospective Study

TypeobservationalSponsorSara Mahmoud Ahmed MahmoudRan2025 to 2026Enrolled87ConditionsBladder Urothelial CarcinomaArmsChemotherapy with platine
NCT07051083 recruitingnot on this mapstarted 2024, after this paper: background citation

Intelligent Diagnosis of Bladder Cancer Staging and Prediction of New Adjuvant Chemotherapy Efficacy Based on Deep Learning and Transfer Learning in Ultrasound-Magnetic Resonance-Pathology Multimodal Multiscale

Typeobservational_patient_registrySponsorSun Yat-Sen Memorial Hospital of Sun Yat-Sen UniversityRan2024 to 2026Enrolled480ConditionsBladder Cancer, Staging, Deep Learning, Neoadjuvant ChemotherapyArmsRisk Stratification
3 · Its place in the literature

Who cites it

231 citing papers in PubMed, 10 syntheses or guidelines pooled it, 468 citations in OpenAlex.

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

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 3 institutions in 2 countries.

Ming YinDepartment of Hematology and Oncology, Penn State Hershey Medical Center, Hershey, Pennsylvania, USA.
Monika JoshiDepartment of Hematology and Oncology, Penn State Hershey Medical Center, Hershey, Pennsylvania, USA.
Richard P MeijerDepartment of Urology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands Department of Urology, University Medical Center Utrecht, Utrecht, The Netherlands.
Michael GlantzDepartment of Neurosurgery, Penn State Hershey Medical Center, Hershey, Pennsylvania, USA.
Sheldon HolderDepartment of Hematology and Oncology, Penn State Hershey Medical Center, Hershey, Pennsylvania, USA.
Harold A HarveyDepartment of Hematology and Oncology, Penn State Hershey Medical Center, Hershey, Pennsylvania, USA.
Matthew KaagDepartment of Urology, Penn State Hershey Medical Center, Hershey, Pennsylvania, USA jdrabick@hmc.psu.edu.
Elisabeth E Fransen van de PutteDepartment of Urology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
Simon HorenblasDepartment of Urology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
Joseph J DrabickDepartment of Hematology and Oncology, Penn State Hershey Medical Center, Hershey, Pennsylvania, USA jdrabick@hmc.psu.edu.
Penn State Milton S. Hershey Medical Center · USThe Netherlands Cancer Institute · NLUniversity Medical Center Utrecht · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPlatinum-based neoadjuvant chemotherapy has been shown to improve survival outcomes in muscle-invasive bladder cancer patients. We performed a systematic review and meta-analysis to provide updated results of previous findings. We also summarized published data to compare clinical outcomes of methotrexate, vinblastine, doxorubicin, and cisplatin (MVAC) versus gemcitabine and cisplatin/carboplatin (GC) in the neoadjuvant setting.

methodsA meta-analysis of 15 randomized clinical trials was performed to compare neoadjuvant chemotherapy plus local treatment with the same local treatment alone. Because no randomized trials have investigated MVAC versus GC in the neoadjuvant setting, a meta-analysis of 13 retrospective studies was performed to compare MVAC with GC.

resultsA total of 3,285 patients were included in 15 randomized clinical trials. There was a significant overall survival (OS) benefit associated with cisplatin-based neoadjuvant chemotherapy (hazard ratio [HR], 0.87; 95% confidence interval [CI], 0.79-0.96). A total of 1,766 patients were included in 13 retrospective studies. There was no significant difference in pathological complete response between MVAC and GC. However, GC was associated with a significantly reduced overall survival (HR, 1.26; 95% CI, 1.01-1.57). After excluding carboplatin data, GC still seemed to be inferior to MVAC in OS (HR, 1.31; 95% CI, 0.99-1.74), but the difference was no longer statistically significant.

conclusionThese results support the use of cisplatin-based combination neoadjuvant chemotherapy in muscle-invasive bladder cancer. Although GC and MVAC had similar treatment response rates, the different survival outcome observed in this study requires further investigation. IMPLICATIONS FOR PRACTICE: Platinum-based neoadjuvant chemotherapy (NCT) has been shown to improve survival outcomes in muscle-invasive bladder cancer (MIBC) patients, but the optimal neoadjuvant regimen has not been established. Methotrexate, vinblastine, doxorubicin, and cisplatin (MVAC) and gemcitabine and cisplatin/carboplatin (GC) are two of the most commonly used chemotherapy regimens in modern oncology. In this two-step meta-analysis, an updated and more precise estimate of the survival benefit of cisplatin-based NCT in MIBC is provided. This study also demonstrated that MVAC might have superior overall survival compared with GC (with or without carboplatin data) in the neoadjuvant setting. The findings suggest that NCT should be standard care in MIBC, and MVAC could be the preferred neoadjuvant regimen.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsChemotherapy, AdjuvantCisplatinHumansNeoadjuvant TherapyNeoplasm InvasivenessUrinary Bladder NeoplasmsCisplatinBladder cancerChemotherapyNeoadjuvantPlatinumSurvival

Identifiers

PMID27053504
PMCPMC4912364
OpenAlexW2332342311

What OpenQuestion holds

Textmetadata
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.