Systemic anticancer therapy for urothelial carcinoma: UK oncologists' perspective

Area of Science:

• Oncology
• Urothelial Carcinoma Research

Background:

• Urothelial carcinoma (UC) presents a poor prognosis in advanced stages.
• Platinum-based chemotherapy is a long-standing, effective treatment for UC.
• Recent advancements have improved outcomes in UC management.

Purpose of the Study:

• To review systemic treatment options for urothelial carcinoma (UC).
• To provide UK-specific interpretations of current standards of care for UC.
• To highlight clinical data supporting treatment pathways for advanced UC.

Main Methods:

• Review of clinical data for systemic anticancer treatments in UC.
• Analysis of treatment pathways from a UK perspective.
• Inclusion of author interpretations on current standards of care.

Main Results:

• Neoadjuvant cisplatin chemotherapy is recommended for muscle-invasive bladder cancer.
• First-line advanced UC treatment involves platinum chemotherapy followed by avelumab maintenance.
• Immune checkpoint inhibitors (ICIs) are options for platinum-ineligible patients with PD-L1 positive tumors.

Conclusions:

• Systemic therapy for UC has evolved, offering improved outcomes.
• Treatment sequencing is crucial, with options like enfortumab vedotin for later lines.
• Areas for further research include optimal chemotherapy cycles and PD-L1 testing value.