Disparities in Access to Novel Systemic Therapies in Patients With Urinary Tract Cancer: Propagating Access, Policies and Resources Uniformly.

After several decades of therapeutic stagnation, the treatment of patients with urothelial carcinoma has met a revolutionary wave, anticipated by the advent of immune-checkpoint inhibitors (ICI) and followed by newer therapeutic options in the post-ICI setting. These achievements were made in a very short time-frame, thus making the treatment of this disease particularly susceptible to geographical health disparity due to the differences in healthcare systems and approval processes of the regulatory authorities. Furthermore, additional barriers to access innovative care are represented by a limited coverage of clinical trials availability, that is consistent in focusing on selected geographical areas, across trials and clinical settings. Here, we present the current picture of new drug approvals in urothelial carcinoma worldwide, and we also focus our considerations onto the spectrum of ongoing trial inclusion possibilities, trying to understand what are the current gaps in clinical research and routine practice, identifying a way to move forward.

Clinical genitourinary cancer. 2022 Oct 13 [Epub ahead of print]

Andrea Necchi, Monika Joshi, Rick Bangs, Lydia Makaroff, Petros Grivas, Ashish M Kamat, Wassim Kassouf, Daniele Raggi, Laura Marandino, Tracey Krupski, Thomas W Flaig, Philippe E Spiess, Global Society of Rare Genitourinary Tumors (GSRGT) and the International Bladder Cancer Group (IBCG)

Vita-Salute San Raffaele University, Milan, Italy; Department of Medical Oncology, IRCCS Ospedale San Raffaele, Milan, Italy. Electronic address: ., Department of Medicine, Division of Hematology-Oncology, Penn State Cancer Institute, Hershey, PA., SWOG Cancer Research Network, Portland, OR; Bladder Cancer Advocacy Network, Bethesda, MD., World Bladder Cancer Patient Coalition, Brussels, Belgium., Department of Medicine, Division of Medical Oncology, University of Washington; Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA., Department of Urology, University of Texas MD Anderson Cancer Center, Houston, TX., Department of Surgery (Urology), McGill University Health Center, Montreal, QC, Canada., Department of Medical Oncology, IRCCS Ospedale San Raffaele, Milan, Italy., University of Virginia, Charlottesville, VA., University of Colorado Cancer Center, Aurora, CO., Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL.

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