Abstract
Purpose: To review the management of metastatic upper tract urothelial carcinoma (UTUC) including recent advances in targeted and immune therapies as an update to the 2014 joint international consultation on UTUC, co-sponsored by the Société Internationale d’Urologie and International Consultation on Urological Diseases. Methods: A PubMed database search was performed between January 2013 and May 2016 related to the treatment of metastatic UTUC, and 54 studies were selected for inclusion. Results: The management of patients with metastatic UTUC is primarily an extrapolation from evidence guiding the management of metastatic urothelial carcinoma of the bladder. The first-line therapy for metastatic UTUC is platinum-based combination chemotherapy. Standard second-line therapies are limited and ineffective. Patients with UTUC who progress following platinum-based chemotherapy are encouraged to participate in clinical trials. Recent advances in genomic profiling present exciting opportunities to guide the use of targeted therapy. Immunotherapy with checkpoint inhibitors has demonstrated extremely promising results. Retrospective studies provide support for post-chemotherapy surgery in appropriately selected patients. Conclusions: The management of metastatic UTUC requires a multi-disciplinary approach. New insights from genomic profiling using targeted therapies, novel immunotherapies, and surgery represent promising avenues for further therapeutic exploration.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 367-378 |
| Number of pages | 12 |
| Journal | World Journal of Urology |
| Volume | 35 |
| Issue number | 3 |
| DOIs | |
| State | Published - Mar 1 2017 |
Fingerprint
Keywords
- Anti-PD-1
- Anti-PD-L1
- Chemotherapy
- Immune checkpoint inhibitors
- Immunotherapy
- Targeted therapy
- Upper tract urothelial carcinoma (UTUC)
ASJC Scopus subject areas
- Urology
Cite this
Upper tract urothelial carcinoma topical issue 2016 : treatment of metastatic cancer. / Pham, M. N.; Apolo, A. B.; De Santis, M.; Galsky, M. D.; Leibovich, B. C.; Pisters, L. L.; Siefker-Radtke, A. O.; Sonpavde, G.; Steinberg, G. D.; Sternberg, C. N.; Tagawa, S. T.; Weizer, A. Z.; Woods, M. E.; Milowsky, M. I.
In: World Journal of Urology, Vol. 35, No. 3, 01.03.2017, p. 367-378.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Upper tract urothelial carcinoma topical issue 2016
T2 - treatment of metastatic cancer
AU - Pham, M. N.
AU - Apolo, A. B.
AU - De Santis, M.
AU - Galsky, M. D.
AU - Leibovich, B. C.
AU - Pisters, L. L.
AU - Siefker-Radtke, A. O.
AU - Sonpavde, G.
AU - Steinberg, G. D.
AU - Sternberg, C. N.
AU - Tagawa, S. T.
AU - Weizer, A. Z.
AU - Woods, M. E.
AU - Milowsky, M. I.
PY - 2017/3/1
Y1 - 2017/3/1
N2 - Purpose: To review the management of metastatic upper tract urothelial carcinoma (UTUC) including recent advances in targeted and immune therapies as an update to the 2014 joint international consultation on UTUC, co-sponsored by the Société Internationale d’Urologie and International Consultation on Urological Diseases. Methods: A PubMed database search was performed between January 2013 and May 2016 related to the treatment of metastatic UTUC, and 54 studies were selected for inclusion. Results: The management of patients with metastatic UTUC is primarily an extrapolation from evidence guiding the management of metastatic urothelial carcinoma of the bladder. The first-line therapy for metastatic UTUC is platinum-based combination chemotherapy. Standard second-line therapies are limited and ineffective. Patients with UTUC who progress following platinum-based chemotherapy are encouraged to participate in clinical trials. Recent advances in genomic profiling present exciting opportunities to guide the use of targeted therapy. Immunotherapy with checkpoint inhibitors has demonstrated extremely promising results. Retrospective studies provide support for post-chemotherapy surgery in appropriately selected patients. Conclusions: The management of metastatic UTUC requires a multi-disciplinary approach. New insights from genomic profiling using targeted therapies, novel immunotherapies, and surgery represent promising avenues for further therapeutic exploration.
AB - Purpose: To review the management of metastatic upper tract urothelial carcinoma (UTUC) including recent advances in targeted and immune therapies as an update to the 2014 joint international consultation on UTUC, co-sponsored by the Société Internationale d’Urologie and International Consultation on Urological Diseases. Methods: A PubMed database search was performed between January 2013 and May 2016 related to the treatment of metastatic UTUC, and 54 studies were selected for inclusion. Results: The management of patients with metastatic UTUC is primarily an extrapolation from evidence guiding the management of metastatic urothelial carcinoma of the bladder. The first-line therapy for metastatic UTUC is platinum-based combination chemotherapy. Standard second-line therapies are limited and ineffective. Patients with UTUC who progress following platinum-based chemotherapy are encouraged to participate in clinical trials. Recent advances in genomic profiling present exciting opportunities to guide the use of targeted therapy. Immunotherapy with checkpoint inhibitors has demonstrated extremely promising results. Retrospective studies provide support for post-chemotherapy surgery in appropriately selected patients. Conclusions: The management of metastatic UTUC requires a multi-disciplinary approach. New insights from genomic profiling using targeted therapies, novel immunotherapies, and surgery represent promising avenues for further therapeutic exploration.
KW - Anti-PD-1
KW - Anti-PD-L1
KW - Chemotherapy
KW - Immune checkpoint inhibitors
KW - Immunotherapy
KW - Targeted therapy
KW - Upper tract urothelial carcinoma (UTUC)
UR - http://www.scopus.com/inward/record.url?scp=84976330400&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84976330400&partnerID=8YFLogxK
U2 - 10.1007/s00345-016-1885-4
DO - 10.1007/s00345-016-1885-4
M3 - Article
C2 - 27342991
AN - SCOPUS:84976330400
VL - 35
SP - 367
EP - 378
JO - World Journal of Urology
JF - World Journal of Urology
SN - 0724-4983
IS - 3
ER -