Updates in the management and future landscape of urothelial carcinoma

J Oncol Pharm Pract. 2021 Mar;27(2):435-444. doi: 10.1177/1078155220971026. Epub 2020 Nov 3.

Abstract

Urothelial carcinoma is the sixth most common cancer type in the United States. Although most patients present with early stage disease which is associated with improved outcomes, many will progress to locally advanced or metastatic disease. Immune checkpoint inhibitors have significantly impacted the treatment paradigm for patients and have resulted in improved survival rates. Despite their proven efficacy, many ongoing clinical trials continue to refine combinations with chemotherapy, sequencing of therapies and the role of ligand expression. Additionally, novel targets have been identified for advanced urothelial carcinoma and have led to the approval of the antibody-drug conjugate, enfortumab vedotin, and the fibroblast growth factor receptor-targeted, erdafitinib. Enrollment in a clinical trial is strongly encouraged for all stages of advanced or metastatic disease. Numerous ongoing clinical trials are likely to impact the treatment armamentarium for patients. In this manuscript, we highlight key updates in the clinical management for patients and outline ongoing trials.

Keywords: Urothelial carcinoma; bladder cancer; clinical trials; immune checkpoint inhibitors.

Publication types

  • Review

MeSH terms

  • Antibodies, Monoclonal / therapeutic use*
  • Carcinoma, Transitional Cell / drug therapy*
  • Clinical Trials as Topic
  • Humans
  • Immune Checkpoint Inhibitors / therapeutic use*
  • Immunoconjugates / therapeutic use
  • Survival Rate

Substances

  • Antibodies, Monoclonal
  • Immune Checkpoint Inhibitors
  • Immunoconjugates
  • enfortumab vedotin