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24.06.2016 | Topic Paper

Upper tract urothelial carcinoma topical issue 2016: treatment of metastatic cancer

verfasst von: M. N. Pham, A. B. Apolo, M. De Santis, M. D. Galsky, B. C. Leibovich, L. L. Pisters, A. O. Siefker-Radtke, G. Sonpavde, G. D. Steinberg, C. N. Sternberg, S. T. Tagawa, A. Z. Weizer, M. E. Woods, M. I. Milowsky

Erschienen in: World Journal of Urology | Ausgabe 3/2017

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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.

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Titel: Upper tract urothelial carcinoma topical issue 2016: treatment of metastatic cancer
verfasst von: M. N. Pham
A. B. Apolo
M. De Santis
M. D. Galsky
B. C. Leibovich
L. L. Pisters
A. O. Siefker-Radtke
G. Sonpavde
G. D. Steinberg
C. N. Sternberg
S. T. Tagawa
A. Z. Weizer
M. E. Woods
M. I. Milowsky
Publikationsdatum: 24.06.2016
Verlag: Springer Berlin Heidelberg
Erschienen in: World Journal of Urology / Ausgabe 3/2017
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-016-1885-4

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Upper tract urothelial carcinoma topical issue 2016: treatment of metastatic cancer