scholarly journals Management of muscle invasive, locally advanced and metastatic urothelial carcinoma of the bladder: a literature review with emphasis on the role of surgery

2016 ◽  
Vol 5 (5) ◽  
pp. 735-744 ◽  
Author(s):  
Mohammad Abufaraj ◽  
Kilian Gust ◽  
Marco Moschini ◽  
Beat Foerster ◽  
Francesco Soria ◽  
...  
Keyword(s):  
Literature Review ◽  
Urothelial Carcinoma ◽  
Locally Advanced ◽  
Metastatic Urothelial Carcinoma ◽  
Carcinoma Of The Bladder ◽  
Muscle Invasive

Study EV-103: Preliminary durability results of enfortumab vedotin plus pembrolizumab for locally advanced or metastatic urothelial carcinoma.

2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 441-441 ◽  
Author(s):  
Jonathan E. Rosenberg ◽  
Thomas W. Flaig ◽  
Terence W. Friedlander ◽  
Matthew I. Milowsky ◽  
Sandy Srinivas ◽  
...  
Keyword(s):  
Urothelial Carcinoma ◽  
Locally Advanced ◽  
Sensory Neuropathy ◽  
Multiple Organ ◽  
Antibody Drug Conjugate ◽  
Metastatic Urothelial Carcinoma ◽  
Previously Treated ◽  
Muscle Invasive ◽  
Platinum Chemotherapy ◽  
Peripheral Sensory

441 Background: Platinum chemotherapy is the standard for patients (pts) with metastatic urothelial carcinoma (mUC) in the first line (1L) setting. In cisplatin-ineligible pts, gem/carbo is a standard therapy, but is poorly tolerated with limited durability and survival. PD-1/PD-L1 inhibitors, such as pembrolizumab (P), have shown promising durability in this setting for PD-L1 high patients. Enfortumab vedotin (EV) is an antibody-drug conjugate that delivers the microtubule-disrupting agent MMAE to cells expressing Nectin-4, which is highly expressed in UC. EV has shown activity in previously treated mUC. Initial EV + P data were previously presented (Hoimes ESMO 2019); this provides first durability data and an update on safety/ORR. Methods: This multicohort study (NCT03288545) evaluated the safety/activity of EV + P. We report a cohort of 1L cis-ineligible patients treated with EV 1.25 mg/kg + P. In each 3-week cycle, EV was administered on Days 1 and 8 and P on Day 1. The primary endpoint was safety/tolerability; secondary objectives included determination of recommended EV dose, ORR, DCR, DOR/PFS per RECIST v1.1, and OS. Results: As of 8 Oct 2019, 45 mUC pts (median age 69 yr [51–90]) received a median of 9 (range 1-22) cycles of EV + P. The most common treatment-emergent adverse events (AE) were fatigue (58%, 11% ≥G3), alopecia (53%), and peripheral sensory neuropathy (53%, 4% ≥G3). One pt died due to an AE reported as related (multiple organ failure). With a median follow-up of 11.5 mo, confirmed investigator-assessed ORR was 73.3% (95% CI, 58.1, 85.4) including 15.6% CRs; DCR was 93.3%. The ORR in pts with liver metastasis was 53.3% (8/15). The ORR in pts with available PD-L1 status was 78.6% in PD-L1 high (11/14) and 63.2% in PD-L1 low (12/19). Of the 33 responders, 18 (55%) have ongoing responses including 11 responses beyond 10 months. The median DOR was not reached (range 1.2 to 12.9+ mo). The median PFS was 12.3 mo (95% CI, 7.98, -). Conclusions: In 1L cis-ineligible pts with mUC, EV + P, a potential platinum free option, demonstrates promising activity and durability, with a manageable safety profile. Further evaluation of EV + P in mUC and muscle-invasive UC is ongoing. Clinical trial information: NCT03288545.

1990 THE ROLE OF RADICAL SURGERY FOR METASTATIC UROTHELIAL CARCINOMA OF THE BLADDER: AN ANALYSIS OF THE SEER DATABASE

2011 ◽  
Vol 185 (4S) ◽  
Author(s):  
Daniel Canter ◽  
Alexander Kutikov ◽  
Marc Smaldone ◽  
Brian Egleston ◽  
Yu-Ning Wong ◽  
...  
Keyword(s):  
Urothelial Carcinoma ◽  
Radical Surgery ◽  
Seer Database ◽  
Metastatic Urothelial Carcinoma ◽  
Carcinoma Of The Bladder

scholarly journals Detection of PD-L1 in the urine of patients with urothelial carcinoma of the bladder

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Georgi Tosev ◽  
Wasilijiang Wahafu ◽  
Philipp Reimold ◽  
Ivan Damgov ◽  
Constantin Schwab ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Urothelial Carcinoma ◽  
Locally Advanced ◽  
Invasive Bladder Cancer ◽  
Therapeutic Monitoring ◽  
Tumor Evolution ◽  
Muscle Invasive Bladder Cancer ◽  
Programmed Death ◽  
Carcinoma Of The Bladder ◽  
Muscle Invasive

AbstractThere are currently five programmed death-1 (PD-1)/programmed death ligand-1 (PD-L1) inhibitors approved for the treatment of locally advanced or metastatic urothelial carcinoma (UC) of the bladder. For platinum-ineligible patients, testing of tumor specimens for PD-L1 expression is required. However, scoring of PD-L1 immunohistochemistry is complex due to different antibodies used, the requirement to score expression in different cellular compartments and intratumoral heterogeneity. It can also be difficult to obtain and test longitudinal tumor samples, which would be desirable to monitor treatment responses and tumor evolution under treatment-induced selective pressure. In the present proof-of concept study, we provide evidence that PD-L1 can be detected in the urine of patients with non-muscle invasive bladder cancer (NMIBC) and muscle-invasive bladder cancer (MIBC). Urine PD-L1 levels were significantly higher in NMIBC and MIBC patients when compared to patients with various non-malignant urological diseases. Further prospective and independent studies are required to assess the value of PD-L1 in the urine as a novel biomarker with potential for the early detection, prediction and therapeutic monitoring of patients with UC of the bladder.

Association of persistent, unexplained leukocytosis, a paraneoplastic syndrome, with poor prognosis in patients with urothelial carcinoma of the bladder.

2013 ◽  
Vol 31 (6_suppl) ◽  
pp. 291-291
Author(s):  
Jason Patrick Izard ◽  
John L. Gore ◽  
Evan Y. Yu
Keyword(s):  
Urothelial Carcinoma ◽  
Poor Prognosis ◽  
Locally Advanced ◽  
Laboratory Data ◽  
Substantial Reduction ◽  
Case Series ◽  
Invasive Disease ◽  
Carcinoma Of The Bladder ◽  
Muscle Invasive ◽  
The University

291 Background: Unexplained leukocytosis, thought to be associated with paraneoplastic GCSF, has been described in several malignancies and is linked to a poor prognosis. We sought to define the disease characteristics and outcomes of those patients presenting with urothelial carcinoma and a persistently elevated WBC. Methods: We queried a prospectively maintained database at the University of Washington. Patients were included if they had a histological diagnosis of urothelial carcinoma of the bladder and a WBC of >20 x 103cells/µl. Patient charts were reviewed and were excluded from analysis if the leukocytosis was not persistent in duration or if an underlying cause for the leukocystosis could be identified. Clinical, histological and laboratory data were then collected from the remaining patient cohort. Results: We identified a total of 44 patients who met the inclusion criteria of having urothelial carcinoma of the bladder with a WBC of >20 x 103cells/µl. Of these patients, 7 (16%) patients with a median age of 61.9 (range 34 - 80) yrs at diagnosis had persistent, unexplained leukocytosis. Mixed histologies were present in 3 patients (extensive squamous differentiation in 2 and sarcomatoid differentiation in 1). At the time of presentation with leukocytosis, 5 of 7 had muscle invasive disease and 3 had evidence of metastatic disease. Leukocytosis was frequently associated with hypercalcemia (n = 5), thrombocytosis (n = 5) and anemia (n = 6). All patients died from their disease with the exception of one who is currently alive with locally advanced and unresectable disease 8 months after presentation. Median time from leukocytosis until death was 55 (range 8 - 139) days. Chemotherapy was able to achieve a WBC response in 2 of 4 patients although neither demonstrated a substantial reduction in tumor volume. Both patients ultimately developed a recurrence of their leukocytosis after chemotherapy and progression of their disease. Conclusions: The presence of leukocytosis conveys a poor prognosis. To our knowledge this represents the largest case series of patients with paraneoplastic leukocytosis secondary to urothelial carcinoma.

PD-L1 testing for urothelial carcinoma: Interchangeability, reliability and future perspectives

2020 ◽  
Vol 21 ◽  
Author(s):  
Thomas Gevaert ◽  
Alessia Cimadamore ◽  
Rodolfo Montironi ◽  
Markus Eckstein
Keyword(s):  
Urothelial Carcinoma ◽  
Locally Advanced ◽  
Upper Urinary Tract ◽  
First Line ◽  
Programmed Death ◽  
Emerging Issues ◽  
Metastatic Urothelial Carcinoma ◽  
Programmed Death 1 ◽  
Carcinoma Of The Bladder ◽  
Scoring Algorithms

: Five programmed death-1/programmed death-ligand 1 (PD-L1) inhibitors are currently approved for the treatment of locally advanced or metastatic urothelial carcinoma of the bladder and the upper urinary tract. Following the FDA and EMA restrictions of first-line treatment with Atezolizumab and Pembrolizumab in platinum-ineligible patients, immunohistochemical PD-L1 testing is now required. Several emerging issues on antibodies, test platforms and scoring algorithms have raised concerns about the comparability and interchangeability between these assays. In this review we have focused on the interchangeability of the used algorithms and assays for PD-L1 testing in urothelial carcinoma, on the predictive reliability of PD-L1 testing in urothelial carcinoma and the potential of other new and upcoming biomarkers.

Sign in / Sign up

Export Citation Format

Share Document