Beyond first-line systemic treatment for metastatic urothelial carcinoma of the bladder

Metastatic urothelial carcinoma of the bladder is a rarely curable disease. Patients receive systemic therapy with limited response rates and survival benefits. The rescue regimens of these patients who have failed first-line treatment had remained problematic until the recent advances. Several trials with novel regimens, including immune checkpoint inhibitors and targeted therapy, to salvage relapsed urothelial carcinoma of the bladder have recently been published. However, the choice of an optimal treatment regimen remains challenging in the absence of randomized trials comparing regimen sequences. Daily clinical cases provoke the question of whether there is a preferred second-line regimen. This paper provides an overview of recent trials and proposes a management algorithm based on subgroup analyses and prognostic features.

Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico. 2018 Sep 04 [Epub ahead of print]

E El Rassy, T Assi, Z Bakouny, N Pavlidis, J Kattan

Department of Medical Oncology, Faculty of Medicine, Hotel Dieu de France University Hospital, Saint Joseph University, Adib Ishaac Street, Beirut, Lebanon., Department of Medical Oncology, Faculty of Medicine, Hotel Dieu de France University Hospital, Saint Joseph University, Adib Ishaac Street, Beirut, Lebanon. ., University of Ioannina, Niarchos Avenue, 45110, Ioannina, Greece.