The Absolute Effect / Evidence / BA06 30894
Bladder Cancer · Medical Oncology · Neoadjuvant
BA06 30894
Clinical question
Does neoadjuvant cisplatin-based chemotherapy improve survival before definitive local treatment of muscle-invasive bladder cancer?
Trial context
Population
976 patients with muscle-invasive urothelial bladder cancer
Intervention
Three cycles CMV chemotherapy + definitive local therapy vs definitive local therapy alone
Key endpoint
Overall survival
Time horizon / follow-up
10 years
Absolute Effect
What changes for patients?
Neoadjuvant CMV increased 10-year OS from 30% to 36%, an absolute benefit of 6 percentage points (NNT 17). It also reduced metastasis or death. NNT is based on 10-year overall survival.
NNT: 17
Treatment burden / harm
Chemotherapy toxicity
NNH: Not quantifiable from the long-term publication; acute chemotherapy toxicity should be described rather than forcing an NNH
Relative effect
HR: 0.84
95% CI 0.72–0.99; P=.037
Clinical interpretation
The key clinical takeaway is the survival benefit of cisplatin-based neoadjuvant chemotherapy before cystectomy in eligible MIBC; the original CMV regimen should be interpreted alongside newer perioperative options.
Primary publication
- International Collaboration of Trialists. J Clin Oncol. 2011;29:3513–3519.
- Primary publication / source