Efficacy of neoadjuvant chemotherapy and combined immunotherapy in muscle-invasive bladder cancer:a single-center real-world retrospective study
Objective:To investigate the efficacy and safety of the neoadjuvant regimen of bladder cancer chemotherapy combined with immunotherapy in the treatment of patients with muscle-invasive bladder cancer(MI-BC).Methods:Clinical data of a total of 56 MIBC patients admitted to First Affiliated Hospital of Nanjing Medi-cal University were collected and analyzed.The patients were divided into two groups according to the different neoadjuvant treatment regimens;the chemotherapy group used gemcitabine combined with cisplatin,and the com-bination group added an immune checkpoint blocker on the basis of this chemotherapy.The pathological down-stage rate,pathological complete remission rate and short-to-medium term adverse reaction rate and other related indexes of the two groups were compared.Results:In the combination group,12 patients achieved pathological complete remission(ypT0)(54.5％),5 patients(22.7％)partial remission(ypT1),with a pathological downstag-ing rate of 77.3％and a pathological complete remission rate of 54.5％,whereas in the chemotherapy group,8 patients(23.5％)achieved complete remission,6 patients(17.6％)partial remission,with a pathological down-staging rate of 41.2％,and the pathological complete remission rate was 23.5％,with statistical differences be-tween the two groups(P＜0.05),There was no statistically significant difference in the rate of pathological down-staging or pathological complete remission between subgroups of the combined group(P＞0.05).No serious aller-gic reactions or adverse events leading to patient's death occurred in the two groups,and there were no grade 4 ad-verse events.The rate of grade 3 adverse events in the combination group was 45.6％,higher than that in the chemotherapy group(35.3％),but there was no statistically significant difference(P＞0.05).Conclusion:The neoadjuvant chemotherapy regimen of gemcitabine and cisplatin chemotherapy combined with immunotherapy can significantly increase the pathological downstage rate and pathological complete remission rate of patients,but does not significantly increase the incidence of short-to-medium term grade 3 adverse events,which can be safely applied.
bladder cancerneoadjuvant chemotherapyimmunotherapymuscle-invasive bladder cancer
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