Evolving systemic management of urothelial cancers

Tan, Wei Shen; Tan, Mae-Yen; Alhalabi, Omar; Campbell, Matthew T.; Kamat, Ashish M.; Gao, Jianjun

doi:10.1097/cco.0000000000000942

Cited by 3 publications

(2 citation statements)

References 63 publications

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“…This is especially critical for patients with locally advanced and metastatic bladder cancer, with the average life expectancy in patients with metastatic disease being less than two years. [91]…”

Section: Bladder Cancermentioning

confidence: 99%

Hyaluronan Metabolism in Urologic Cancers

Donelan,

Brisbane,

O'Malley

et al. 2023

Advanced Biology

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Hyaluronan (HA) is one of the major components of the extracellular matrix in tumor tissue. Recent reports have made it clear that the balance of HA synthesis and degradation is critical for tumor progression. HA is synthesized on the cytoplasmic surface of the plasma membrane by hyaluronan synthases (HAS) and extruded into the extracellular space. Excessive HA production in cancer is associated with enhanced HA degradation in the tumor microenvironment, leading to the accumulation of HA fragments with small molecular weight. These perturbations in both HA synthesis and degradation may play important roles in tumor progression. Recently, it has become increasingly clear that small HA fragments can induce a variety of biological events, such as angiogenesis, cancer‐promoting inflammation, and tumor‐associated immune suppression. Progression of urologic malignancies, particularly of prostate and bladder cancers, as well as of certain types of kidney cancer show markedly perturbed metabolism of tumor‐associated HA. This review highlights the recent research findings regarding HA metabolism in tumor microenvironments with a special focus on urologic cancers. It also will discuss the potential implications of these findings for the development of novel therapeutic interventions for the treatment of prostate, bladder, and kidney cancers.

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Section: Bladder Cancermentioning

confidence: 99%

Hyaluronan Metabolism in Urologic Cancers

Donelan,

Brisbane,

O'Malley

et al. 2023

Advanced Biology

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“…In MIBC, neoadjuvant chemotherapy followed by radical cystectomy is the preferred treatment option. In cases of locally advanced or metastatic MIBC, treatment may also involve biomarker-guided immune checkpoint inhibitors (ICI), targeted therapies, or other novel drug conjugates ( 2 ). Although there has been significant progress in bladder cancer research, as well as in the optimization of therapeutic approaches, the survival rate and prognosis remain poor, particularly for patients with advanced bladder cancer.…”

mentioning

confidence: 99%

Editorial: Tumor microenvironment in bladder cancer

Kusmartsev

Grizzi

2023

Front. Oncol.

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Evolving Treatment Landscape of Frontline Therapy for Metastatic Urothelial Carcinoma: Current Insights and Future Perspectives

Kwon,

Lee

2024

Cancers

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Cisplatin-based chemotherapy has long been the standard first-line (1L) treatment for metastatic urothelial carcinoma (mUC). However, up to 50% of patients with mUC may be ineligible for cisplatin owing to comorbidities, necessitating alternative primary treatment options. Immune checkpoint inhibitors (ICIs) have emerged as a vital alternative for those unable to receive cisplatin. Nevertheless, the prognosis of advanced UC remains dire and challenges persist in optimizing 1L therapy. Recent medical advancements have redirected attention towards innovative drug combinations for the primary treatment of mUC. The combination of enfortumab vedotin (EV) and pembrolizumab has shown significantly improved overall and progression-free survival rates compared to those with chemotherapy alone. This combination can be used as a 1L treatment for patients with mUC who are cisplatin-ineligible or require alternatives to standard chemotherapy. While platinum-based chemotherapy continues to be essential for many patients, the approval of EV and pembrolizumab as 1L treatments for cisplatin-ineligible patients signifies a major breakthrough in primary cancer care. These therapies offer enhanced outcomes in terms of survival and response rates and highlight the increasing relevance of ICI-containing regimens in frontline cancer care. This review provides an exhaustive overview of the current frontline treatment landscape of mUC and explores new therapeutic strategies, with the aim of facilitating clinical decision-making and guiding therapeutic strategies in patients with mUC.

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Evolving systemic management of urothelial cancers

Cited by 3 publications

References 63 publications

Hyaluronan Metabolism in Urologic Cancers

Hyaluronan Metabolism in Urologic Cancers

Editorial: Tumor microenvironment in bladder cancer

Evolving Treatment Landscape of Frontline Therapy for Metastatic Urothelial Carcinoma: Current Insights and Future Perspectives

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