Bladder Cancer, Version 3.2020, NCCN Clinical Practice Guidelines in Oncology

Flaig, Thomas W.; Spiess, Philippe E.; Agarwal, Neeraj; Bangs, Rick; Boorjian, Stephen A.; Buyyounouski, Mark K.; Chang, Sam S.; Downs, Tracy M.; Efstathiou, Jason A.; Friedlander, Terence W.; Greenberg, Richard E.; Guru, Khurshid A.; Guzzo, Thomas; Herr, Harry W.; Hoffman-Censits, Jean H.; Hoimes, Christopher J.; Inman, Brant A.; Jimbo, Masahito; Kader, A. Karim; Lele, Subodh M.; Michalski, Jeff M.; Montgomery, Jeffrey S.; Nandagopal, Lakshminarayanan; Pagliaro, Lance C.; Pal, Sumanta K.; Patterson, Anthony; Plimack, Elizabeth R.; Pohar, Kamal S.; Preston, Mark A.; Sexton, Wade J.; Siefker‐Radtke, Arlene O.; Tward, Jonathan D.; Wright, Jonathan L.; Gurski, Lisa A.; Johnson-Chilla, Alyse

doi:10.6004/jnccn.2020.0011

Cited by 489 publications

(458 citation statements)

References 136 publications

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“…Gemcitabine is one of the standard of care drugs for the treatment of metastatic bladder cancer [ 33 , 34 ]. Therefore, we tested the activity of EphA2-ILs-DTXp in combination with gemcitabine and compared it to either drug alone.…”

Section: Resultsmentioning

confidence: 99%

Targeting EphA2 in Bladder Cancer Using a Novel Antibody-Directed Nanotherapeutic

et al. 2020

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Ephrin receptor A2 (EphA2) is a member of the Ephrin/Eph receptor cell-to-cell signaling family of molecules, and it plays a key role in cell proliferation, differentiation, and migration. EphA2 is overexpressed in a broad range of cancers, and its expression is in many cases associated with poor prognosis. We recently developed a novel EphA2-targeting antibody-directed nanotherapeutic encapsulating a labile prodrug of docetaxel (EphA2-ILs-DTXp) for the treatment of EphA2-expressing malignancies. Here, we characterized the expression of EphA2 in bladder cancer using immunohistochemistry in 177 human bladder cancer samples and determined the preclinical efficacy of EphA2-ILs-DTXp in four EphA2-positive patient-derived xenograft (PDX) models of the disease, either as a monotherapy, or in combination with gemcitabine. EphA2 expression was detected in 80–100% of bladder cancer samples and correlated with shorter patient survival. EphA2 was found to be expressed in tumor cells and/or tumor-associated blood vessels in both primary and metastatic lesions with a concordance rate of approximately 90%. The EphA2-targeted antibody-directed nanotherapeutic EphA2-ILs-DTXp controlled tumor growth, mediated greater regression, and was more active than free docetaxel at equitoxic dosing in all four EphA2-positive bladder cancer PDX models. Combination of EphA2-ILs-DTXp and gemcitabine in one PDX model led to improved tumor growth control compared to monotherapies or the combination of free docetaxel and gemcitabine. These data demonstrating the prevalence of EphA2 in bladder cancers and efficacy of EphA2-ILs-DTXp in PDX models support the clinical exploration of EphA2 targeting in bladder cancer.

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Section: Resultsmentioning

confidence: 99%

Targeting EphA2 in Bladder Cancer Using a Novel Antibody-Directed Nanotherapeutic

et al. 2020

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“…[15][16][17][18][19] However, if as per the tumor board discussion that the cure cannot be expected or the patients refuse the definitive treatment, for these patients, palliative therapy, RT, and palliative surgery are often performed for the purpose of symptom relief and supportive care. 5,20 Palliative RT has good tolerance and good costperformance characteristics. 21,22 The main aim of palliative RT is to provide adequate symptomatic relief throughout a patient's anticipated life span.…”

Section: Discussionmentioning

confidence: 99%

Palliative Radiation Therapy for Macroscopic Hematuria Caused by Urothelial Cancer

Zhang

Hojo

Raturi

et al. 2020

Palliative Medicine Reports

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Background: To assess the efficacy and toxicity profiles of palliative radiation therapy (RT) for macroscopic hematuria (MH) caused by urothelial cancer. Methods: A total of 25 urothelial cancer patients with MH who underwent palliative RT between 2008 and 2018 were analyzed in this retrospective study. The hematuria-free survival (HFS) time was defined as the period from complete resolution of MH to the recurrence of MH, death, or the last follow-up examination. Adverse events were classified according to the Common Terminology Criteria for Adverse Events version 4.0. Results: By the end of the median follow-up duration of 90 days (11-886 days), complete resolution of MH had been achieved in 22 patients (88%), and the median interval between the start of RT and resolution of MH was 9 days (2-179 days). Of the 22 patients in whom the symptom resolved, 9 (41%) developed recurrent MH, and the median time to relapse of MH was 129 days (30-692 days). The median RT dose was 30 Gy (20-40 Gy). Nine (36%) patients received a blood transfusion before the RT. The three-month HFS rate was 52.1%. There was a significant difference in the three-month HFS rate between patients with and without a history of pretreatment blood transfusion (HFS rate: 34.6% vs. 61.5%, p = 0.03). Grade 2 urinary tract pain and grade 3 diarrhea were seen in one patient each. Conclusion: Palliative RT appeared to be effective with limited toxicities for urothelial cancer patients with MH.

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“…In recent years, ICIs have become standard 2L care of metastatic UC after platinum‐based chemotherapy . Currently, there are a total of five ICIs available for this indication, all of which received accelerated U.S. Food and Drug Administration (FDA) approval (Table )…”

Section: Metastatic Disease Treatmentmentioning

confidence: 99%

Immunotherapy for urothelial carcinoma: Metastatic disease and beyond

Poon

2020

Asia-Pac J Clncl Oncology

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For advanced and metastatic urothelial carcinomas (UCs), platinum (preferably cisplatin)‐based chemotherapy has been the standard treatment for many years. However, many patients are ineligible for cisplatin‐based chemotherapy because of poor performance status and/or other age‐related conditions. At the other end of the spectrum, patients with localized non‐muscle–invasive bladder cancer who are unresponsive to intravesical Bacillus Calmette‐Guérin (BCG) treatment often face radical cystectomy as the only option. In recent years, the application of immunotherapy in the form of immune‐checkpoint inhibitors has provided viable alternatives in the second‐line postplatinum and first‐line cisplatin‐ineligible settings. Recent and ongoing clinical trials are also assessing the safety and efficacy of immunotherapy for neoadjuvant and adjuvant uses before/after cystectomy, for BCG‐unresponsive cases, and for combination treatments that include the newer indoleamine 2,3‐dioxygenase‐1 inhibitors and/or BCG. This review summarizes recent developments in immunotherapy for UCs.

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Bladder Cancer, Version 3.2020, NCCN Clinical Practice Guidelines in Oncology

Cited by 489 publications

References 136 publications

Targeting EphA2 in Bladder Cancer Using a Novel Antibody-Directed Nanotherapeutic

Targeting EphA2 in Bladder Cancer Using a Novel Antibody-Directed Nanotherapeutic

Palliative Radiation Therapy for Macroscopic Hematuria Caused by Urothelial Cancer

Immunotherapy for urothelial carcinoma: Metastatic disease and beyond

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