The role of radiotherapy in metastatic bladder cancer

Perera, Jananie; Hoskin, Peter

doi:10.20517/2394-4722.2021.167

Cited by 2 publications

(1 citation statement)

References 49 publications

(64 reference statements)

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“…In patients with LA/mUC, radiation therapy is applied as palliative treatment at the discretion of the treating physician [ 70 ]. It might offer limited symptom control of brain and bone metastasis or symptomatic primary bladder tumors.…”

Section: Investigational Regimens In Cisplatin-ineligible Metastatic ...mentioning

confidence: 99%

Revisiting Treatment of Metastatic Urothelial Cancer: Where Do Cisplatin and Platinum Ineligibility Criteria Stand?

Moussa,

Campbell,

Alhalabi

2024

Biomedicines

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Cisplatin-based chemotherapy has been the standard of care in metastatic urothelial cancer (mUC) for more than two decades. However, many patients with comorbidities cannot receive cisplatin or its alternative, carboplatin. ‘Cisplatin-ineligible’ and ‘platinum-ineligible’ patients lacked effective therapy options. However, the recent combination of enfortumab vedotin (EV), an antibody–drug conjugate targeting Nectin-4, with pembrolizumab (P), an antibody targeting the programmed death-1 (PD-1) immune checkpoint, is changing the status quo of frontline mUC treatment, with potential synergy seen in the EV-103 and EV-302 clinical trials. First, we review the working definitions of ‘cisplatin ineligibility’ and ‘platinum ineligibility’ in mUC clinical trials and the standard of care in both categories. Then, we review select clinical trials for frontline treatment of cisplatin- and platinum-ineligible mUC patients on ClinicalTrials.gov. We classify the investigated drugs in these trials by their therapeutic strategies. Alongside chemotherapy combinations, the field is witnessing more immunotherapy combinations with fibroblast growth factor receptor (FGFR) inhibitors, bicycle toxin conjugates, bispecific antibodies, innovative targeted therapies, and many others. Most importantly, we rethink the value of classifying patients by cisplatin or platinum ineligibility in the frontline setting in the post-EVP era. Lastly, we discuss new priority goals to tailor predictive, monitoring, and prognostic biomarkers to these emergent therapies.

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Section: Investigational Regimens In Cisplatin-ineligible Metastatic ...mentioning

confidence: 99%