The Quickly Evolving Treatment Landscape of Metastatic Urothelial Carcinoma: A New Standard of Care in First-Line Systemic Therapy
Written by Zachary Klaassen, MD, MSc Associate Professor of Urology Urologic Oncologist Medical College of Georgia, Georgia Cancer Center Augusta, GA and Rashid Sayyid, MD, MSc Urologic Oncology Fellow University of Toronto Toronto, Ontario, Canada
March 13, 2024
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.
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The Treatment Landscape of Metastatic Urothelial Carcinoma: Second-Line Systemic Therapy
Written by Zachary Klaassen, MD, MSc Associate Professor of Urology Urologic Oncologist Medical College of Georgia, Georgia Cancer Center Augusta, GA and Rashid Sayyid, MD, MSc Urologic Oncology Fellow University of Toronto Toronto, Ontario, Canada
September 14, 2023
For patients with metastatic urothelial carcinoma, first line therapy for cisplatin eligible patients remains platinum-based chemotherapy
1 (followed by maintenance avelumab
2), whereas those that are cisplatin ineligible may receive gemcitabine + carboplatin
3 (followed by maintenance avelumab
2)
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The Treatment Landscape of Metastatic Urothelial Carcinoma: First-Line Systemic Therapy in Cisplatin Eligible Patients
Written by Zachary Klaassen, MD, MSc Associate Professor of Urology Urologic Oncologist Medical College of Georgia, Georgia Cancer Center Augusta, GA and Rashid Sayyid, MD, MSc Urologic Oncology Fellow University of Toronto Toronto, Ontario, Canada
August 29, 2023
Metastatic urothelial carcinoma is associated with a poor prognosis, with a median overall survival of less than two years. To date, combination platinum-based chemotherapy remains the standard of care first line treatment for these patients who are suitable for chemotherapy.
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The Current Landscape of Neoadjuvant Chemotherapy/Immunotherapy Combinations in Patients with Clinically Localized, Muscle Invasive Bladder Cancer
Written by Rashid K. Sayyid, MD, MSc, and Zachary Klaassen, MD, MSc
March 21, 2023
Neoadjuvant cisplatin-based chemotherapy combinations have demonstrated five-year overall survival benefits of around 5%
5 and pathologic complete responses rates of 36 to 42% with contemporary chemotherapy regimens.
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The Current Landscape of Neoadjuvant Chemotherapy in Cisplatin Eligible Patients with Clinically Localized, Muscle Invasive Bladder Cancer
Written by Rashid K. Sayyid, MD, MSc, and Zachary Klaassen, MD, MSc
March 21, 2023
Early treatment intensification with neoadjuvant cisplatin-based chemotherapy has long been advocated as means to improve survival outcomes in patients with clinically localized, muscle invasive disease undergoing definitive local therapy.
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The Current Landscape of Neoadjuvant Immunotherapy Agent Combinations in Patients with Clinically Localized, Muscle Invasive Bladder Cancer
Written by Rashid K. Sayyid, MD, MSc, and Zachary Klaassen, MD, MSc
March 20, 2023
While neoadjuvant cisplatin-based chemotherapy combinations have demonstrated five-year overall survival benefits of at least 5%,
5 a significant proportion of patients remain “cisplatin ineligible”, defined by at least one of the following criteria.
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The Current Landscape of Neoadjuvant Single Agent Therapy in Patients with Cisplatin Ineligible Clinically Localized, Muscle Invasive Bladder Cancer
Written by Rashid K. Sayyid, MD, MSc, and Zachary Klaassen, MD, MSc
March 20, 2023
While the majority of patients are diagnosed with non-muscle invasive disease (i.e. carcinoma in situ, Ta, and T1), approximately 25 to 33% of patients are initially diagnosed with muscle invasive bladder cancer and a meaningful proportion of patients initially diagnosed with non-muscle invasive disease will subsequently progress to MIBC.
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An Update on Muscle Invasive Bladder Cancer and Metastatic Bladder Cancer
Written by Janet Baack Kukreja, MD, MPH and Ashish Kamat, MD, MBBS
April 16, 2019
Bladder cancer was one of the top five leading causes of cancer death in 2015.
1 Most of these cases are of urothelial histologic origin. For about 35% of patients, bladder cancer is either muscle-invasive or metastatic at disease presentation.
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Erdafitinib PI
BALVERSA is a kinase inhibitor indicated for the treatment of adult patients with locally advanced or metastatic urothelial carcinoma that has
- 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
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