Current Therapy for Metastatic Urothelial Carcinoma

Hematol Oncol Clin North Am. 2021 Jun;35(3):469-493. doi: 10.1016/j.hoc.2021.02.010. Epub 2021 Apr 10.

Abstract

Urothelial carcinoma (UC) is a highly lethal malignancy in the metastatic state. Platinum-based chemotherapy regimens have been the backbone treatment for patients with advanced UC in the first-line setting. However, a large subset of patients are suboptimal candidates for these combinations owing to poor renal function and/or other comorbidities. Patients who are unable to tolerate or who progress after frontline platinum chemotherapy face a poor outcome. Recent insights into UC biology and immunology are being translated into new therapies for metastatic UC (mUC) including immune checkpoint inhibitors (ICIs), erdafitinib, a FGFR inhibitor, and antibody drug conjugates (ADC) such enfortumab vedotin.

Keywords: Antibody-drug conjugate; FGFR inhibitor; Immune checkpoint inhibitors; Systemic therapy; Targeted therapy; Urothelial carcinoma.

Publication types

  • Review

MeSH terms

  • Carcinoma, Transitional Cell* / drug therapy
  • Humans
  • Immune Checkpoint Inhibitors / therapeutic use
  • Immunoconjugates / therapeutic use
  • Protein Kinase Inhibitors / therapeutic use
  • Urinary Bladder Neoplasms* / drug therapy

Substances

  • Immune Checkpoint Inhibitors
  • Immunoconjugates
  • Protein Kinase Inhibitors