Neoadjuvant chemotherapy in invasive bladder cancer: update of a systematic review and meta-analysis of individual patient data advanced bladder cancer (ABC) meta-analysis collaboration

Eur Urol. 2005 Aug;48(2):202-5; discussion 205-6. doi: 10.1016/j.eururo.2005.04.006. Epub 2005 Apr 21.


Objectives: To update a systematic review and meta-analysis that assesses the effect of neoadjuvant chemotherapy in the treatment of patients with invasive bladder cancer.

Methods: Following a prespecified protocol, we analysed updated individual patient data from all eligible randomised controlled trials that compared neoadjuvant chemotherapy plus local treatment with the same local treatment alone.

Results: Updated results are based on 11 trials, 3005 patients; comprising 98% of all patients from known eligible randomised controlled trials. We found a significant survival benefit associated with platinum-based combination chemotherapy (HR = 0.86, 95% CI 0.77-0.95, p = 0.003). This is equivalent to a 5% absolute improvement in survival at 5 years. There was also a significant disease-free survival benefit associated with platinum-based combination chemotherapy (HR = 0.78 95% CI 0.71-0.86, p < 0.0001), equivalent to a 9% absolute improvement at 5 years.

Conclusions: These results provide the best available evidence in support of the use of neoadjuvant platinum-based combination chemotherapy.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Systematic Review

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Chemotherapy, Adjuvant
  • Humans
  • Neoadjuvant Therapy
  • Neoplasm Invasiveness
  • Randomized Controlled Trials as Topic
  • Survival Analysis
  • Urinary Bladder Neoplasms / drug therapy*
  • Urinary Bladder Neoplasms / therapy