A dramatic change in the treatment of advanced urothelial carcinomas (UC) occurred in the last 3 years, initially with the development of several check-point inhibitors, for second and first-line therapy. More recently, the approval of anti-FGFR (Fibroblast Growth Factor Receptor) and anti-nectin-4 inhibitors based on phase 2 studies in refractory disease, and the preliminary results of 3 randomized phase 3 trials combining chemotherapy and immunotherapy in first-line as well as using maintenance immunotherapy after chemotherapy induction, created a new paradigm in the treatment of metastatic disease. In this review, we will explore the new classes of agents and how they could be incorporated in the clinical practice as well as the results of recently presented randomized studies, guiding oncologists on the possible sequences for patients with advanced urothelial carcinoma.
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http://dx.doi.org/10.1016/j.critrevonc.2021.103248 | DOI Listing |
Explor Target Antitumor Ther
November 2024
Oncology Institute of Southern Switzerland (IOSI), Ente Ospedaliero Cantonale (EOC), 6500 Bellinzona, Switzerland.
Advanced urothelial carcinoma (aUC) has a dismal prognosis, with a 5-year survival rate of approximately 10%. Platinum-based chemotherapy has been the backbone of the first-line treatment of aUC for over 40 years. Only in the last decade, the treatment of aUC has evolved and been enriched with new classes of drugs that demonstrated pivotal improvements in terms of oncological responses and, ultimately, survival.
View Article and Find Full Text PDFFront Oncol
December 2024
Department of Urology, Seoul National University Hospital, Seoul, Republic of Korea.
Introduction: We evaluated the prognostic potential of the Beta-human chorionic gonadotropin (β-hCG), Carbohydrate Antigen 19-9 (CA19-9), Cancer Antigen 125 (CA125), and Carcinoembryonic Antigen (CEA) tumor markers for bladder cancer.
Methods: We analyzed the records of 369 patients who underwent radical cystectomy for urothelial cancer (UC) between October 2012 until December 2019. Levels of CA19-9, CA125, CEA, and β-hCG before radical cystectomy were measured in all patient samples, and serum biomarker cutoff values were used as normal and elevated values.
Zhonghua Bing Li Xue Za Zhi
January 2025
Department of Pathology, School of Basic Medical Sciences, Third Hospital, Peking University Health Science Center, Beijing100191, China.
Immune checkpoint inhibitors targeting PD-1/PD-L1 are gradually being applied in the treatment of advanced urinary system tumors. Immunohistochemical analysis of PD-L1 expression is the most popular method for screening suitable patients for immunotherapy and predicting therapeutic efficacy. The current application status of PD-L1 detection for urinary system tumors (mainly urothelial carcinoma), methods of the different antibody tests and the precautions, challenges and solutions in the interpretation of immunostaining were summarized in this review.
View Article and Find Full Text PDFJCO Precis Oncol
January 2025
Department of Urology, Kyoto University School of Medicine, Kyoto, Japan.
Purpose: Circulating tumor DNA (ctDNA) analysis is an alternative to tissue biopsy for genotyping in various cancers. We aimed to establish a plasma ctDNA sequencing assay, then evaluate its clinical utility in advanced urothelial cancer (UC).
Materials And Methods: This study included 82 patients with muscle-invasive or metastatic UC.
Cancer Med
January 2025
Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Purpose: Upper tract urothelial carcinoma (UTUC) presents a higher incidence rate in Taiwan compared to Western societies. The aim of this study is to investigate the potential of metformin in improving survival outcomes for patients with UTUC in Taiwan.
Material And Methods: This retrospective study included 940 patients with UTUC and type 2 diabetes from the Taiwan UTUC Collaboration Group, spanning 21 hospitals from July 1988 to September 2023.
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