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The Latest Research on Advanced Bladder Cancer
Practice Changing Results from Clinical Trials in Metastatic Urothelial Cancer
Urothelial carcinoma (UC) is the most common cancer of the urinary tract and the sixth most frequently diagnosed cancer in the United States.[SEER] Historically, patients with unresectable locally advanced or metastatic urothelial UC (mUC) have had a poor prognosis, particularly if they are platinum-ineligible or if their cancer progresses after platinum-based chemotherapy. However, new treatments and therapeutic combinations are becoming available in first and later-line settings and offer promise for improved clinical outcomes. In this update, I highlight recent results from clinical trials, noting which findings are practice changing and which are worthy of further investigation.
Petros Grivas, MD, Ph.D. is a Professor and the Clinical Director of the Genitourinary Cancers Program at the University of Washington, and an Associate Member of the Clinical Research Division at the Fred Hutchinson Cancer Research Center with expertise in genitourinary cancers such as bladder cancer, prostate cancer, and testis cancer.
Dr. Grivas is dedicated to efficient, personalized and outstanding patient care. He believes in an optimal patient-physician relationship and community outreach. Dr. Petros Grivas was recruited from the Cleveland Clinic where he was leading the bladder/urothelial cancer program and was seeing numerous patients with bladder/urothelial cancer, prostate cancer and testis cancer. Prior to Cleveland Clinic, Dr. Grivas was seeing patients with similar diseases at the University of Michigan, Ann Arbor. He played an important role in clinical trials that led to the FDA approval of new drugs for bladder/urothelial cancer, and he is considered a thought leader and international expert, giving lectures in several countries, educating other oncologists and trainees, leading clinical trials and publishing novel and important research.
Introduction
Metastatic urothelial carcinoma is associated with a poor prognosis, with an estimated 17,000 deaths annually in the United States from this disease.1 Platinum-based chemotherapy had long been considered the standard of care first line treatment for platinum-eligible patients with metastatic urothelial carcinoma. Read More- susceptible FGFR3 or FGFR2 genetic alterations and
- progressed during or following at least one line of prior platinum-containing chemotherapy including within 12 months of neoadjuvant
In an oral abstract presentation on the second day of the American Society for Clinical Oncology (ASCO) Genitourinary Cancer Symposium 2022 Dr. Rosenberg presented results of BAYOU, examining durvalumab and olaparib as first-line therapy in platinum-ineligible patients with unresectable stage IV urothelial carcinoma.
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Closing this course on TMT, Dr. Efstathiou presented on Biomarkers, Immunotherapy and Future Directions in TMT. He began by emphasizing, as many of the prior presentations in the course had done, that clinical-pathologic features affect TMT decisions, including tumor size, T stage, hydronephrosis, renal function, and bladder function. The question then is whether genomic factors may be able to inform bladder sparing therapy.
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