Biomarkers for platinum sensitivity in bladder cancer: are we there yet?

The current standard of care for treating patients with newly diagnosed muscle-invasive bladder cancer (MIBC) is the administration of neoadjuvant cisplatin-based chemotherapy (NAC) followed by radical cystectomy (RC) in surgical candidates. This recommendation is based on level 1 evidence demonstrating improved overall survival for NAC followed by RC compared to RC alone (1,2). The survival benefit from the use of NAC is largely attributable to pathologic downstaging of the primary tumor (3) and the potential eradication of micrometastatic disease.