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Advanced urothelial cancer: a radiology update

  • Special Section: Urothelial Disease
  • Published:
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Abstract

The recent genomic characterization of urothelial carcinoma by the Cancer Genome Atlas Project, made possible by the introduction of high throughput, reduced cost, and sequence analysis, has shed new insights on the biology of advanced disease. In addition, studies on imaging of advanced urothelial carcinoma have widened the knowledge on disease presentation and on pattern of metastatic spread and their correlation with the underlying biology of urothelial carcinoma. The wide range of treatments for advanced urothelial cancer, including combined chemotherapy regimens and immune checkpoint inhibitors, each result in treatment class-specific patterns of response and adverse events. Results of studies point to the need for a reliable biomarker, perhaps with imaging, that predicts prognosis and treatment response to systemic treatment, and can be used to select the most effective treatment while minimizing toxicity. This review of advanced urothelial cancer introduces the latest advances in genetic profiling, the current role of imaging, the radiographic appearance of treatment response and their toxicities, and details potential future areas of imaging research.

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(Reproduced with permission from Sanli O. et al., Nat Rev Dis Primers 2017; Springer nature)

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Authors and Affiliations

  1. Department of Imaging, Dana Farber Cancer Institute, Harvard Medical School, 450 Brookline Avenue, Boston, MA, 02215, USA

    Francesco Alessandrino, Ola Ghaith, Kristin Williams & Atul B. Shinagare

  2. Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA

    Francesco Alessandrino, Ola Ghaith, Kristin Williams, Stuart G. Silverman & Atul B. Shinagare

  3. Lank Center for Genitourinary Oncology, Dana Farber Cancer Institute, Harvard Medical School, 450 Brookline Avenue, Boston, MA, 02215, USA

    Guru P. Sonpavde

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  1. Francesco Alessandrino
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Correspondence to Francesco Alessandrino.

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Guru P. Sonpavde, MD: Consultant for BMS, Exelixis, Bayer, Sanofi, Pfizer, Novartis, Eisai, Janssen, Amgen, Astrazeneca, Merck, Genentech, EMD Serono, Astellas/Agensys; Research support to institution from Astrazeneca, Bayer, Amgen, Boehringer-Ingelheim, Janssen, Merck, Sanofi, Pfizer; Author for Uptodate; Steering committee for Astrazeneca, BMS, Bavarian Nordic; Speaker for Onclive; Research to Practice; Physician Education Resource (PER). Atul B. Shinagare, MD: Relevant: none; unrelated: Consultant, Arog Pharmaceuticals, Virtualscopics. All other authors have no conflict of interest.

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Alessandrino, F., Ghaith, O., Williams, K. et al. Advanced urothelial cancer: a radiology update. Abdom Radiol 44, 3858–3873 (2019). https://doi.org/10.1007/s00261-019-02148-3

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