First line therapy of metastatic urothelial bladder cancer
| Title: | First line therapy of metastatic urothelial bladder cancer |
|---|---|
| Authors: | Lorena Stamičar, Marija Gamulin |
| Source: | Libri Oncologici, Vol 49, Iss 2-3, Pp 94-102 (2021) |
| Publisher Information: | University Hospital for Tumors, 2021. |
| Publication Year: | 2021 |
| Collection: | LCC:Neoplasms. Tumors. Oncology. Including cancer and carcinogens |
| Subject Terms: | first line therapy, metastatic urothelial bladder cancer, maintenance immunotherapy, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282 |
| More Details: | This manuscript reviewes recent knowledge regarding first line therapy of metastatic urothelial bladder cancer. Bladder cancer is on the 10th place in the world by its incidence, and more prevalent in men. Patients with metastatic urothelial cancer should be classified into one of the two groups: cisplatin eligible and cisplatin-ineligible. Cisplatin-eligible can be treated with cisplatin based regimens and have better outcome. Cisplatin-ineligible patients (40-50%) are cisplatin-ineligible patients are primarily those with creatinine clirence les than 50 ml/min, the ones with certain comorbities and/or poor ECOG performance status, and, as an alternative, can be treated with carboplatin which is less effective. After the diagnosis of metastatic bladder cancer has been confirmed, it is necessary to choose one of the cisplatin based chemotherapy regimens. However, one should have in mind that cisplatin can cause certain side effects such as nephrotoxic, neurotoxic and ototoxic effects. A minority of patients are not eligible for any platinum-containing chemotherapy regimen. Besides chemotherapy regimens, checkpoint inhibitors (CPIs)-PD-1 and PD-L1 inhibitors play an important role in first-line therapy of metastatic urothelial cancer. NCCN guidelines have included avelumab, pembrolizumab and atezolizumab in a first-line systemic therapy. Recently, Javelin Bladder 100 study has confirmed a positive impact of avelumab as a maitenance therapy in cisplatin-eligible and cisplatin-ineligible patients, which is why the combination of chemotherapy and avelumab is nowadays deemed to be the best therapeutic option. |
| Document Type: | article |
| File Description: | electronic resource |
| Language: | English |
| ISSN: | 0300-8142 2584-3826 |
| Relation: | https://hrcak.srce.hr/file/389021; https://doaj.org/toc/0300-8142; https://doaj.org/toc/2584-3826 |
| DOI: | 10.20471/LO.2021.49.02-03.13 |
| Access URL: | https://doaj.org/article/15b653385bf643cbb07e1f9c30be5194 |
| Accession Number: | edsdoj.15b653385bf643cbb07e1f9c30be5194 |
| Database: | Directory of Open Access Journals |
| ISSN: | 03008142 25843826 |
|---|---|
| DOI: | 10.20471/LO.2021.49.02-03.13 |
| Published in: | Libri Oncologici |
| Language: | English |