Cytidine Deaminase Activity Assessment to Select Perioperative Chemotherapy Regimen in Localized Bladder Cancer

The optimal perioperative chemotherapy regimen in localized bladder cancer is still unknown. The cisplatin-gemcitabine regimen is a reasonable alternative to accelerated methotrexate, vincristine, cisplatin, and adriamycin in this setting in terms of efficacy. Gemcitabine is a prodrug transformed into active metabolites; however, 90% of gemcitabine is inactivated by cytidine deaminase. The assessment of serum cytidine deaminase activity can identify patients at high risk of gemcitabine-induced severe hematologic toxicity that can result in treatment delay and dose intensity reduction. (C) 2017 Elsevier Inc. All rights reserved.