The impact of these rapid advances for both urothelial carcinoma patients and the research community is difficult to overstate. Prior to this recent renaissance, investment in urothelial carcinoma drug development was scant from both the private and public sectors. The belief that urothelial carcinoma patients were too frail to be treated safely, that urothelial carcinoma trials could not accrue well, and that urothelial carcinoma did not possess therapeutically exploitable biology or targets was a widely held dogma. Besides achieving their primary goal of improving the lives of patients with urothelial carcinoma, the FDA approvals shown in Figure 1 resoundingly demonstrated to the world that urothelial carcinoma is a fertile ground for new drug registration strategies. This point has forever changed urothelial carcinoma from a patient population with few clinical trial options to a population with an abundance of trials to choose from across all stages of the disease. Shown in Figure 2 is a snapshot of recently completed, ongoing, and planned FDA registration trials in urothelial carcinoma. With multiple registration trials anticipated to read out in the next few years in the front-line metastatic, adjuvant, and BCG-unresponsive non-muscle invasive populations, continued rapid evolution in standards of care and scientific discovery are anticipated. While change can evoke fear of the unknown, in the case of urothelial carcinoma this should not be the case. Indeed, our biggest unknown about the changes that will follow is how far further we will improve the outlook for patients with urothelial carcinoma. For this fact, urothelial carcinoma patients, families, and physician providers are justifiably hopeful and tremendously thankful.
Published Date: July 12th, 2019