Advanced urothelial cancer: a radiology update
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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.
KeywordsUrothelial carcinoma Transitional cell Urinary bladder neoplasms Computed tomography X-ray Programmed cell death-1 receptor Neoplasm Metastasis
Compliance with ethical standards
Conflict of interest
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.
This article does not contain any studies with human participants or animals performed by any of the authors.
Statement of informed consent is not applicable since the manuscript does not contain any patient data.
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