Targeted therapy for advanced urothelial cancer of the bladder: where do we stand?

Zhaowei Zhu1, Zhoujun Shen, Chen Xu

  • 1Department of Urology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.

Insights

Novel targeted therapies show promise for advanced urothelial bladder cancer, but results vary. Bevacizumab and trastuzumab offer benefits, while other agents need further investigation for improved patient outcomes.

Area of Science:

  • Oncology
  • Pharmacology

Background:

  • Chemotherapy remains standard for advanced urothelial bladder cancer, offering survival benefits but causing significant side effects.
  • Targeted therapies represent a promising new direction for improving patient outcomes by targeting specific molecular pathways.

Purpose of the Study:

  • To systematically review clinical data on novel targeted agents for advanced urothelial bladder cancer.
  • To evaluate the efficacy of agents like bevacizumab, aflibercept, sunitinib, sorafenib, gefitinib, lapatinib, trastuzumab, pazopanib, cetuximab, and everolimus.

Main Methods:

  • Systematic review of 10 phase II clinical trials.
  • Analysis of clinical data for various targeted agents in urothelial bladder cancer treatment.

Main Results:

  • Bevacizumab and trastuzumab demonstrated promising results in advanced urothelial bladder cancer.
  • Other targeted agents did not achieve the same clinical benefit as observed in other epithelial cancers.
  • The efficacy of targeted agents varies significantly in this patient population.

Conclusions:

  • Targeted therapy offers a promising avenue for advanced urothelial bladder cancer, though efficacy differs among agents.
  • Combination, sequential, adjuvant, and neoadjuvant targeted therapy approaches may offer the best outcomes.
  • Further research is needed to optimize targeted therapy strategies for urothelial bladder cancer.

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