The comparison of oncologic outcomes between metastatic upper tract urothelial carcinoma and urothelial carcinoma of the bladder after cisplatin-based chemotherapy

Hsieh, Meng‐Che; Chiang, Po‐Hui; Rau, Kun‐Ming; Chen, Yen‐Yang; Su, Yu-Li; Huang, Cheng-Hua

doi:10.1016/j.urolonc.2015.07.001

Cited by 17 publications

(23 citation statements)

References 28 publications

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“…The median survival time for our MUC patients receiving continuous maintenance chemotherapy was 17 months, with no difference between bladder and upper urinary tract cancer location (18 versus 17 months). The survival time was compatible with previous reports (1,13,14). Patient survival was likely related not only to the objective tumor response, but also to inflammation and coagulopathy as major contributory factors to patient death, as demonstrated by the inflammation-related symptoms and cause of death.…”

Section: Discussionsupporting

confidence: 89%

Survival Benefit for Patients With Metastatic Urothelial Carcinoma Receiving Continuous Maintenance Chemotherapy

Liaw

Liao

Tsui

et al. 2019

In Vivo

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Background/Aim: Urothelial carcinoma is a chemo-sensitive cancer. We investigated the contributory factors to survival benefit of metastatic urothelial carcinoma (MUC) patients receiving continuous maintenance chemotherapy. Patients and Methods: Inclusion criteria were: i) pathology-confirmed urothelial carcinoma, ii) metastatic lesions identified mainly on pre-therapy computed tomography (CT) scans, and iii) inpatient-administered chemotherapy of at least three cycles. Chemotherapy regimens included 5-fluorouracil, leucovorin, cisplatin, and gemcitabine. Results: A total of 139 cases were enrolled in this study. The overall objective response rate was 60% and the median survival time was 17 months. Eight-two (59%) patients had inflammation-related symptoms following the course of chemotherapy. Fifty-five (41%) patients survived more than two years. All patients exhibited various fibrosis formations. No patient experienced unfavorable metastatic conditions. Inflammation-related symptoms remained in 28 (51%) patients. We found that surgery, invasive procedures, and infection likely led to a rapid tumor progression. Conclusion: Continuous maintenance chemotherapy targeting chemo-sensitive tumors, administered at metronomic intervals and focus on tumor microenvironment, can increase MUC survival benefits.

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Section: Discussionsupporting

confidence: 89%

Survival Benefit for Patients With Metastatic Urothelial Carcinoma Receiving Continuous Maintenance Chemotherapy

Liaw

Liao

Tsui

et al. 2019

In Vivo

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“…Urothelial carcinoma (UC) is the most common cancer of the epithelium lining the urinary tract, and can be divided into upper urinary tract cancers, including renal pelvis carcinoma and ureteral carcinoma, as well as lower urinary tract cancers, including bladder cancer and urinary tract cancer (urethra cancer). UC is a malignant tumor that has become the fourth and eighth most common cancer in men and women, respectively, in the United States [ 1 ]. Upper tract urothelial carcinoma (UTUC) is a relatively rare condition in urothelial tumors in Western countries.…”

Section: Introductionmentioning

confidence: 99%

“…Upper tract urothelial carcinoma (UTUC) is a relatively rare condition in urothelial tumors in Western countries. However, there is specific high incidence in Taiwan [ 1 ]. Therefore, developing new therapeutic and diagnostic strategies for the treatment is necessary.…”

Section: Introductionmentioning

confidence: 99%

MiR-30a-5p Inhibits Epithelial-to-Mesenchymal Transition and Upregulates Expression of Tight Junction Protein Claudin-5 in Human Upper Tract Urothelial Carcinoma Cells

Chung

Kao

et al. 2017

IJMS

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The involvement of microRNAs (miRNAs) in cancer development and their potential as prognostic biomarkers are becoming increasingly known. However, the signature of miRNAs and their regulatory roles in tumorigenesis of upper tract urothelial carcinoma (UTUC) remain to be elucidated. This study aimed to profile the miRNA expression pattern in UTUC tumor tissues and identify candidate miRNAs with prognostic and/or therapeutic functions. Methods and Results: We collected 22 UTUC tissue and adjacent normal tissues samples from patients who underwent nephroureterectomy. The miRNAs signatures of three selected UTUC samples using next-generation sequencing showed that miR-30a-5p was significantly downregulated in UTUC tumors compared to adjacent normal tissues. The differentially-expressed miRNAs were specifically validated by quantitative real-time polymerase chain reaction. In addition, the miRNA expression signatures were analyzed with the transcriptome profile characterized by microarray. Further in vitro studies indicated that overexpression of miR-30a-5p significantly suppressed proliferation, migration, and epithelial-to-mesenchymal transition (EMT) in cultured BFTC-909 UTUC cells. As a potential target gene of miR-30a-5p in the tight junction pathway suggested by the pathway enrichment analysis, the reduced expression of tight junction protein claudin-5 in UTUC cells was demonstrated to be upregulated by miR-30a-5p genetic delivery. Conclusions: Taken together, our findings demonstrated that miR-30a-5p inhibits proliferation, metastasis, and EMT, and upregulates the expression of tight junction claudin-5 in UTUC cells. Thus, miR-30a-5p may provide a promising therapeutic strategy for UTUC treatment.

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“…Although there are currently insufficient data recommendations, platinum‐based chemotherapy including cisplatin plus gemcitabine or the combination of methotrexate, vinblastine, doxorubicin, and cisplatin is expected to have similar efficacy as in bladder cancer . However, the vast majority of UC patients treated with these regimens develop progressive disease within 8 months, and survival is very short after the platinum‐based chemotherapy failure . Many second‐line regimens have been tested for advanced or metastatic UC in the past decade, but most have shown limited activity in patients with platinum‐based chemotherapy refractory disease.…”

mentioning

confidence: 99%

“…(6) However, the vast majority of UC patients treated with these regimens develop progressive disease within 8 months, and survival is very short after the platinum-based chemotherapy failure. (7)(8)(9) Many second-line regimens have been tested for advanced or metastatic UC in the past decade, but most have shown limited activity in patients with platinum-based chemotherapy refractory disease. Furthermore, chemotherapy-related toxicities often require treatment cessation, and may reduce survival in patients with postoperative renal dysfunction.…”

mentioning

confidence: 99%

Personalized peptide vaccination as second‐line treatment for metastatic upper tract urothelial carcinoma

et al. 2017

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This study investigated the applicability of personalized peptide vaccination (PPV) for patients with metastatic upper tract urothelial cancer (mUTUC) after failure of platinum‐based chemotherapy. In this single arm, open‐label, phase II clinical trial, patients with mUTUC received PPV at a single institution. Personalized peptide vaccination treatment used a maximum of four peptides chosen from 27 candidate peptides according to human leukocyte antigen types and peptide‐reactive IgG titers, for six s.c. injections weekly as one cycle. The safety of PPV, as well as its influence on host immunity and effect on overall survival were assessed. Forty‐eight patients were enrolled in this study. Personalized peptide vaccinations were well tolerated without severe adverse events. Median survival time was 7.3 months (95% confidence interval [CI], 5.3–13.1) with 13.0 months for patients receiving combined salvage chemotherapy (95% CI, 5.7–17.5) and 4.5 months for patients receiving PPV alone (95% CI, 1.7–10.1) (P = 0.080). Patients with positive CTL responses showed a significantly longer survival than patients with negative CTL responses (hazard ratio, 0.37; 95% CI, 0.16–0.85; P = 0.019). Multivariate Cox regression analysis showed that lower numbers of Bellmunt risk factors and lower levels of B‐cell activating factor were significantly associated with favorable overall survival for patients under PPV treatment. This study indicated that PPV for patients with mUTUC after failure of platinum‐based chemotherapy induced substantial peptide‐specific CTL responses without severe adverse events and has the potential to prolong survival when combined with salvage chemotherapy. UMIN Clinical Trials Registry ID: 000001854.

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The comparison of oncologic outcomes between metastatic upper tract urothelial carcinoma and urothelial carcinoma of the bladder after cisplatin-based chemotherapy

Cited by 17 publications

References 28 publications

Survival Benefit for Patients With Metastatic Urothelial Carcinoma Receiving Continuous Maintenance Chemotherapy

Survival Benefit for Patients With Metastatic Urothelial Carcinoma Receiving Continuous Maintenance Chemotherapy

MiR-30a-5p Inhibits Epithelial-to-Mesenchymal Transition and Upregulates Expression of Tight Junction Protein Claudin-5 in Human Upper Tract Urothelial Carcinoma Cells

Personalized peptide vaccination as second‐line treatment for metastatic upper tract urothelial carcinoma

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