Advances in Therapy for Urothelial and Non-Urothelial Subtype Histologies of Advanced Bladder Cancer: From Etiology to Current Development

Biomedicines, Journal Year: 2025, Volume and Issue: 13(1), P. 86 - 86

Published: Jan. 1, 2025

Urothelial carcinoma (UC) is the most common histological subtype of bladder tumors; however, cancer represents a heterogeneous group diseases with at least 40 distinct subtypes. Among these, 2022 World Health Organization classification urinary tract tumors identifies range less subtypes invasive UC, formerly known as variants, which are considered high-grade tumors, including squamous cell, small-cell, sarcomatoid urothelial, micropapillary, plasmacytoid, and urachal carcinomas, adenocarcinoma. Their accurate diagnosis critical for risk stratification therapeutic decision-making, histologies associated poorer outcomes than conventional UC. Despite importance precise diagnosis, high-quality evidence on optimal treatments remains limited owing to their rarity. In particular, neoadjuvant adjuvant chemotherapy have not been well characterized, prospective data scarce. For advanced-stage diseases, clinical trial participation strongly recommended address lack robust evidence. Advances in molecular pathology development targeted therapies immunotherapies reshaped our understanding subtypes, spurring efforts identify predictive biomarkers guide personalized treatment strategies. Nevertheless, management rare subgroups challenging because they frequently excluded from trials. localized disease, curative options such surgical resection or radiotherapy available; become more recurrence metastasis, where systemic therapy primarily used control disease progression palliate symptoms. Herein, we present recent advances urothelial non-urothelial also explore current guiding emphasize challenges perspectives future

Language: Английский

---

Unmet Potential of Antibody-Drug Conjugates: An Evaluation of the Past, Present, and Future of Antibody-Drug Conjugate Development in Advanced Urothelial Carcinoma

American Society of Clinical Oncology Educational Book, Journal Year: 2025, Volume and Issue: 45(2)

Published: Jan. 1, 2025

Antibody-drug conjugates (ADCs) represent an emerging class of therapeutics across solid tumor oncology and are already positioned as a cornerstone therapy for patients with urothelial carcinoma (UC). In recent years, there has been paradigm shift in the therapeutic landscape frontline treatment UC formerly relied on use platinum-based agents now evolved to include combination strategies ADCs. These dramatic changes due part our improved understanding molecular features bladder tumors identification tumor-associated antigens specific UC, which may serve druggable targets. Despite notable advances clinical success ADCs other malignancies, their full potential remains largely unmet. Early enfortumab vedotin sacituzumab govitecan demonstrated antitumor activity; however, multiple challenges these ADCs, including on-target, off-tumor toxicity difficulty maintaining sustained responses. Newer-generation ADC constructs, either alone or approaches, currently under investigation. This review examines historical development, current landscape, trends highlighting both progress made obstacles that continue hinder optimal outcomes.

Language: Английский

---

Individualisierung und Standardisierung in der Kopf-Hals-Pathologie

HNO, Journal Year: 2025, Volume and Issue: unknown

Published: April 16, 2025

Zusammenfassung Individualisierung und Standardisierung sind scheinbar widersprüchliche Anforderungen in der Medizin. In Tumorbehandlung von Kopf-Hals-Karzinomen haben beide Begriffe direkten Einfluss auf die Diagnostik, welche üblicherweise pathologischen Instituten durchgeführt wird. Im vorliegenden Referat wird das Spannungsfeld zwischen technischen Untersuchungen, regulatorischen Anforderungen, strukturellen Änderungen durch Digitalisierung dem Einzug personalisierten Medizin beleuchtet. Ziel ist zum einen, ein Verständnis Herausforderungen den interdisziplinären Austausch zu fördern, anderen sollen HNO-Arzt ganz praktisch gängigen Untersuchungen nähergebracht werden. Am Beispiel Pathologie lässt sich so schlussendlich zeigen, dass Verfahren einer Verbesserung individuellen Behandlung dient. Zugleich lassen aber auch ablesen: Trotz umfassender Regularien sowie Laborumgebung mit digitaler Unterstützung sehr zeit- kostenaufwendig. Sollen ähnliche Standardisierungsansätze beispielsweise einem operativen Umfeld wie HNO-Chirurgie umgesetzt werden, darf Aufwand aufgrund „menschlichen Komponente“ als gleichwertig oder höher eingeschätzt

---

FGFR Inhibitors in Urothelial Cancer: From Scientific Rationale to Clinical Development

Journal of Korean Medical Science, Journal Year: 2024, Volume and Issue: 39(43)

Published: Jan. 1, 2024

In the past decade, treatment of metastatic urothelial cancer (mUC), including bladder (BC), has transformed significantly with introduction diverse therapies, such as immune checkpoint inhibitors, targeted and antibody-drug conjugates. This change is partly due to advancements in genomic understanding, particularly next-generation sequencing, which identified numerous mutations UC. Among these erdafitinib, a pan-fibroblast growth factor receptor (FGFR) inhibitor for specific FGFR2 FGFR3 alterations, only therapy approved till now. 2019, erdafitinib became pivotal mUC, patients FGFR alterations. Recent studies have highlighted benefits combining immunotherapy, thereby broadening options. Ongoing investigations exist on its use non-muscle-invasive BC combination drugs enfortumab vedotin mUC. Other FGFR-targeted agents are under development; however, overcoming resistance ensuring safety therapies remain major hurdles. prevalent BC, heterogeneous form UC, account considerable proportion new diagnoses annually. Approximately half cancers

Language: Английский

---

Evolving Treatment Landscape of Frontline Therapy for Metastatic Urothelial Carcinoma: Current Insights and Future Perspectives

Cancers, Journal Year: 2024, Volume and Issue: 16(23), P. 4078 - 4078

Published: Dec. 5, 2024

Cisplatin-based chemotherapy has long been the standard first-line (1L) treatment for metastatic urothelial carcinoma (mUC). However, up to 50% of patients with mUC may be ineligible cisplatin owing comorbidities, necessitating alternative primary options. Immune checkpoint inhibitors (ICIs) have emerged as a vital those unable receive cisplatin. Nevertheless, prognosis advanced UC remains dire and challenges persist in optimizing 1L therapy. Recent medical advancements redirected attention towards innovative drug combinations mUC. The combination enfortumab vedotin (EV) pembrolizumab shown significantly improved overall progression-free survival rates compared alone. This can used who are cisplatin-ineligible or require alternatives chemotherapy. While platinum-based continues essential many patients, approval EV treatments signifies major breakthrough cancer care. These therapies offer enhanced outcomes terms response highlight increasing relevance ICI-containing regimens frontline review provides an exhaustive overview current landscape explores new therapeutic strategies, aim facilitating clinical decision-making guiding strategies

Language: Английский

---

State of the art of adjuvant immunotherapy in urothelial cancer: New developments and upcoming changes

Human Vaccines & Immunotherapeutics, Journal Year: 2024, Volume and Issue: 21(1)

Published: Dec. 19, 2024

In recent years, several clinical trials focused on the potential role of immune-checkpoint inhibitors (ICIs) in adjuvant treatment muscle-invasive urothelial cancer (UC). Heretofore, only anti-programmed death protein 1 (anti-PD1) nivolumab received European Medical Agency (EMA) approval for cisplatin-unfit patients. our work, we deeply analyzed results three pivotal studies view rapidly evolving therapeutic advanced UC's scenario. Furthermore, there are ongoing research to investigate ICIs and other emerging immune agents this setting; awaited. Additionally, current efforts have been made assess these earlier disease settings, particularly high-risk non-muscle-invasive bladder (NMIBC). review, predictive and/or prognostic biomarkers that may improve patient selection efficacy. To conclude, highlighted upcoming changes could redefine standard care patients with early-stage UC.

Language: Английский

---