Management of metastatic bladder cancer

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• dc.contributor.author Nadal, Rosa
• dc.contributor.author Bellmunt Molins, Joaquim, 1959-
• dc.date.accessioned 2019-11-22T08:52:39Z
• dc.date.issued 2019
• dc.description.abstract Important advances in the understanding of the biology and mechanisms of tumor progression of urothelial carcinoma (UC) have been achieved over the past decade. The treatment landscape for advanced-stage, unresectable or metastatic UC has shifted dramatically over a short period of time, with 6 new therapeutic agents available for clinical use. The use of traditional chemotherapy and new immune checkpoints inhibitors (ICIs) directed at programmed cell-death protein 1 (PD-1) or its ligand has led to unprecedented survival benefits in selected patients with metastatic UC. Data show that anti-PD-1 ICIs are not only improving long-term clinical benefit, but also quality of life for patients in the second-line setting. In the front-line setting, regulatory agencies have restricted the indications of atezolizumab and pembrolizumab (both ICIs) to patients with PD-L1positivity with advanced UC and who are platinum-ineligible. Very recently, erdafitinib, a pan-FGFR inhibitor, has been granted accelerated approval by FDA for platinum-pretreated advanced metastatic UC with susceptible FGFR3 or FGFR2 genetic alterations. Enfortumab vedotin, an antibody-drug conjugate, have been granted breakthrough designation by the FDA for the treatment of metastatic UC. Here we review the clinical trial data that have established standard-of-care treatment for advanced-stage UC. In addition, mechanisms of resistance and biomarkers of response to platinum-based chemotherapies and immunotherapies are also discussed, along with the clinical benefits and limitations of these therapies.
• dc.format.mimetype application/pdf
• dc.identifier.citation Nadal R, Bellmunt J. Management of metastatic bladder cancer. Cancer Treat Rev. 2019 Jun;76:10-21. DOI 10.1016/j.ctrv.2019.04.002
• dc.identifier.doi http://dx.doi.org/10.1016/j.ctrv.2019.04.002
• dc.identifier.issn 0305-7372
• dc.identifier.uri http://hdl.handle.net/10230/42928
• dc.language.iso eng
• dc.publisher Elsevier
• dc.rights © Elsevier http://dx.doi.org/10.1016/j.ctrv.2019.04.002
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.subject.keyword FGFR genetic alterations
• dc.subject.keyword Immune checkpoint inhibitors
• dc.subject.keyword Metastatic urothelial carcinoma
• dc.subject.keyword Molecular characterization
• dc.subject.keyword Systemic therapy
• dc.title Management of metastatic bladder cancer
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/acceptedVersion