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Current Strategies and Novel Therapeutic Approaches for Metastatic Urothelial Carcinoma

1
Division of Oncology, S.Orsola-Malpighi Hospital, 40138 Bologna, Italy
2
Department of Experimental, Diagnostic and Specialty Medicine, S.Orsola-Malpighi Hospital, 40138 Bologna, Italy
3
Section of Pathological Anatomy, Polytechnic University of the Marche Region, School of Medicine, United Hospitals, 60121 Ancona, Italy
4
Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA
5
Pathology Service, Addarii Institute of Oncology, S-Orsola-Malpighi Hospital, 40138 Bologna, Italy
6
Department of Urology, University of Bologna, S-Orsola-Malpighi Hospital, 40138 Bologna, Italy
7
Oncology Unit, Macerata Hospital, 62100 Macerata, Italy
8
Department of Pathology, University of Bologna, School of Medicine, 40126 Bologna, Italy
9
Unit of Anatomical Pathology, Faculty of Medicine, Cordoba University, 14071 Cordoba, Spain
*
Author to whom correspondence should be addressed.
These authors contribution is equally to this work.
Cancers 2020, 12(6), 1449; https://doi.org/10.3390/cancers12061449
Received: 21 May 2020 / Revised: 29 May 2020 / Accepted: 1 June 2020 / Published: 2 June 2020
(This article belongs to the Section Cancer Therapy)
Urothelial carcinoma (UC) is a frequent cause of cancer-related deaths worldwide. Metastatic UC has been historically associated with poor prognosis, with a median overall survival of approximately 15 months and a 5-year survival rate of 18%. Although platinum-based chemotherapy remains the mainstay of medical treatment for patients with metastatic UC, chemotherapy clinical trials produced modest benefit with short-lived, disappointing responses. In recent years, the better understanding of the role of immune system in cancer control has led to the development and approval of several immunotherapeutic approaches in UC therapy, where immune checkpoint inhibitors have been revolutionizing the treatment of metastatic UC. Because of a better tumor molecular profiling, FGFR inhibitors, PARP inhibitors, anti-HER2 agents, and antibody drug conjugates targeting Nectin-4 are also emerging as new therapeutic options. Moreover, a wide number of trials is ongoing with the aim to evaluate several other alterations and pathways as new potential targets in metastatic UC. In this review, we will discuss the recent advances and highlight future directions of the medical treatment of UC, with a particular focus on recently published data and ongoing active and recruiting trials. View Full-Text
Keywords: urothelial carcinoma; immunotherapy; immune checkpoint inhibitors; FGFR; antibody drug conjugates; clinical trials; PD-1; PD-L1 urothelial carcinoma; immunotherapy; immune checkpoint inhibitors; FGFR; antibody drug conjugates; clinical trials; PD-1; PD-L1
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Mollica, V.; Rizzo, A.; Montironi, R.; Cheng, L.; Giunchi, F.; Schiavina, R.; Santoni, M.; Fiorentino, M.; Lopez-Beltran, A.; Brunocilla, E.; Brandi, G.; Massari, F. Current Strategies and Novel Therapeutic Approaches for Metastatic Urothelial Carcinoma. Cancers 2020, 12, 1449.

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