Evolving systemic management of urothelial cancers

Curr Opin Oncol. 2023 May 1;35(3):186-199. doi: 10.1097/CCO.0000000000000942. Epub 2023 Mar 14.

Abstract

Purpose of review: Bladder cancer is the 12th most common cancer worldwide. Historically, the systemic management of urothelial carcinoma has been confined to platinum-based chemotherapy. In this review, we discuss the evolving landscape of systemic treatment for urothelial carcinoma.

Recent findings: Since 2016, when the Food and Drug Administration approved the first immune checkpoint inhibitor (CPI), programmed cell death 1 and programmed cell death ligand 1 inhibitors have been evaluated in the nonmuscle invasive bladder cancer, localized muscle invasive bladder cancer as well as advanced/metastatic bladder cancer settings. Newer approved treatments such as fibroblast growth factor receptor (FGFR) inhibitors and antibody-drug conjugates (ADCs) represent second-line and third-line options. These novel treatments are now being assessed in combination as well as with older traditional platinum-based chemotherapy.

Summary: Novel therapies continue to improve bladder cancer outcomes. Personalized approach with well validated biomarkers are important to predict response to therapy.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't
  • Research Support, N.I.H., Extramural

MeSH terms

  • Carcinoma, Transitional Cell* / drug therapy
  • Carcinoma, Transitional Cell* / pathology
  • Humans
  • Immune Checkpoint Inhibitors / therapeutic use
  • Immunoconjugates* / therapeutic use
  • Immunotherapy
  • Urinary Bladder Neoplasms* / pathology

Substances

  • Immunoconjugates
  • Immune Checkpoint Inhibitors