Is switching to carboplatin/gemcitabine reasonable for a patient with muscle invasive bladder CA who proceeded to cystectomy first and had AKI with cisplatin/gemcitabine prohibiting further cisplatin?

If not carboplatin, would you recommend nivolumab instead?

Answer from: Medical Oncologist at Academic Institution

There is not a role for gemcitabine and carboplatin in the adjuvant setting in patients with muscle invasive bladder cancer. Based on CheckMate 274 (Bajorin et al., PMID 34077643), in patients with MIBC with a high risk of recurrence (pT3, pT4a, or pN+ and not eligible for or declined adjuvant cispl...

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Medical Oncologist at University of Washington School of Medicine
Great points as usual by the expert @Matthew I. Mi...

Answer from: Medical Oncologist at Community Practice

In a patient who never received neoadjuvant chemotherapy and started adjuvant Gem/Cis or dose dense MVAC but developed AKI during adjuvant chemo- I agree that there is no data for switching to carboplatin-gemcitabine. There is also no data for switching to nivolumab in such patients. However, this s...

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Is switching to carboplatin/gemcitabine reasonable for a patient with muscle invasive bladder CA who proceeded to cystectomy first and had AKI with cisplatin/gemcitabine prohibiting further cisplatin?

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