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Upper tract urothelial carcinoma topical issue 2016 : treatment of metastatic cancer
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Pham, M. N., Apolo, A. B., De Santis, Maria , Galsky, M. D., Leibovich, B. C., Pisters, L. L., Siefker-Radtke, A. O., Sonpavde, G., Steinberg, G. D., Sternberg, C. N., Tagawa, S. T., Weizer, A. Z., Woods, M. E. and Milowsky, M. I. (2017) Upper tract urothelial carcinoma topical issue 2016 : treatment of metastatic cancer. World Journal of Urology, 35 (3). pp. 367-378. doi:10.1007/s00345-016-1885-4 ISSN 0724-4983.
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Official URL: http://dx.doi.org/10.1007/s00345-016-1885-4
Abstract
Purpose: To review the management of metastatic upper tract urothelial carcinoma (UTUC) including recent advances in targeted and immune therapies as an update to the 2014 joint international consultation on UTUC, co-sponsored by the Société Internationale d’Urologie and International Consultation on Urological Diseases.
Methods:A PubMed database search was performed between January 2013 and May 2016 related to the treatment of metastatic UTUC, and 54 studies were selected for inclusion.
Results: The management of patients with metastatic UTUC is primarily an extrapolation from evidence guiding the management of metastatic urothelial carcinoma of the bladder. The first-line therapy for metastatic UTUC is platinum-based combination chemotherapy. Standard second-line therapies are limited and ineffective. Patients with UTUC who progress following platinum-based chemotherapy are encouraged to participate in clinical trials. Recent advances in genomic profiling present exciting opportunities to guide the use of targeted therapy. Immunotherapy with checkpoint inhibitors has demonstrated extremely promising results. Retrospective studies provide support for post-chemotherapy surgery in appropriately selected patients.
Conclusions: The management of metastatic UTUC requires a multi-disciplinary approach. New insights from genomic profiling using targeted therapies, novel immunotherapies, and surgery represent promising avenues for further therapeutic exploration.
Item Type: | Journal Article | ||||||||||
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Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Journal or Publication Title: | World Journal of Urology | ||||||||||
Publisher: | Springer | ||||||||||
ISSN: | 0724-4983 | ||||||||||
Official Date: | March 2017 | ||||||||||
Dates: |
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Volume: | 35 | ||||||||||
Number: | 3 | ||||||||||
Page Range: | pp. 367-378 | ||||||||||
DOI: | 10.1007/s00345-016-1885-4 | ||||||||||
Status: | Peer Reviewed | ||||||||||
Publication Status: | Published | ||||||||||
Access rights to Published version: | Restricted or Subscription Access |
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