2017 saw the publication of clinical trial data and the approval of new treatment approaches for metastatic urothelial carcinoma. Pembrolizumab is now a well-established treatment for patients with disease progression after cisplatin, with high-level evidence supporting its superiority over second-line chemotherapy. For patients ineligible for cisplatin, atezolizumab and pembrolizumab provide meaningful clinical benefit as frontline therapies.
This is a preview of subscription content, log in via an institution to check access.
References
Bellmunt, J. et al. Pembrolizumab as second-line therapy for advanced urothelial carcinoma. N. Engl. J. Med. 376, 1015–1026 (2017).
Balar, A. V. et al. First-line pembrolizumab in cisplatin-ineligible patients with locally advanced and unresectable or metastatic urothelial cancer (KEYNOTE-052): a multicentre, single-arm, phase 2 study. Lancet Oncol. 18, 1483–1492 (2017).
Vaughn, D. J. et al. Health-related quality of life (HRQoL) in the KEYNOTE-045 study of pembrolizumab versus investigator-choice chemotherapy for previously treated advanced urothelial cancer [abstract]. J. Clin. Oncol. 35 (Suppl.), 282 (2017).
Bajorin, D. F. et al. Planned survival analysis from KEYNOTE-045: phase 3, open-label study of pembrolizumab (pembro) versus paclitaxel, docetaxel, or vinflunine in recurrent, advanced urothelial cancer (UC) [abstract]. J. Clin. Oncol. 35 (Suppl.), 4501 (2017).
De Wit, R. V. D. et al. Pembrolizumab (pembro) versus paclitaxel, docetaxel, or vinflunine for recurrent, advanced urothelial cancer (UC): mature results from the phase 3 KEYNOTE-045 trial [abstract]. Ann. Oncol. 28 (Suppl. 5), LBA37_PR (2017).
Dash, A. et al. Impact of renal impairment on eligibility for adjuvant cisplatin-based chemotherapy in patients with urothelial carcinoma of the bladder. Cancer 107, 506–513 (2006).
Balar, A. V. et al. Atezolizumab as first-line treatment in cisplatin-ineligible patients with locally advanced and metastatic urothelial carcinoma: a single-arm, multicentre, phase 2 trial. Lancet 389, 67–76 (2017).
Petrylak, D. P. et al. Docetaxel as monotherapy or combined with ramucirumab or icrucumab in second-line treatment for locally advanced or metastatic urothelial carcinoma: an open-label, three-arm, randomized controlled phase II trial. J. Clin. Oncol. 34, 1500–1509 (2016).
Petrylak, D. P. et al. Ramucirumab plus docetaxel versus placebo plus docetaxel in patients with locally advanced or metastatic urothelial carcinoma after platinum-based therapy (RANGE): a randomised, double-blind, phase 3 trial. Lancet http://dx.doi.org/10.1016/S0140-6736(17)32365-6 (2017).
Author information
Authors and Affiliations
Corresponding authors
Ethics declarations
Competing interests
J.B. has been a consultant for Agensys, Amgen, Astra Zeneca, Bayer, Eisai, Genentech, Janssen, Merck, Novartis, Pfizer, Sanofi, and Seattle Genetics; has received financial support for research from Novartis and Sanofi, and royalties for his UpToDate contribution in urothelial tumours. R.N. declares no competing interests.
PowerPoint slides
Rights and permissions
About this article
Cite this article
Bellmunt, J., Nadal, R. Changes in expectations for metastatic urothelial carcinoma. Nat Rev Clin Oncol 15, 73–74 (2018). https://doi.org/10.1038/nrclinonc.2017.184
Published:
Issue Date:
DOI: https://doi.org/10.1038/nrclinonc.2017.184
- Springer Nature Limited
This article is cited by
-
SLC14A1 (UT-B) gene rearrangement in urothelial carcinoma of the bladder: a case report
Diagnostic Pathology (2020)