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The 2021 Updated European Association of Urology Guidelines on Metastatic Urothelial Carcinoma
- Source :
- European Urology, 81, 95-103, European Urology, 81, 1, pp. 95-103
- Publication Year :
- 2022
- Publisher :
- Elsevier BV, 2022.
-
Abstract
- Contains fulltext : 248305.pdf (Publisher’s version ) (Closed access) CONTEXT: Treatment of metastatic urothelial carcinoma is currently undergoing a rapid evolution. OBJECTIVE: This overview presents the updated European Association of Urology (EAU) guidelines for metastatic urothelial carcinoma. EVIDENCE ACQUISITION: A comprehensive scoping exercise covering the topic of metastatic urothelial carcinoma is performed annually by the Guidelines Panel. Databases covered by the search included Medline, EMBASE, and the Cochrane Libraries, resulting in yearly guideline updates. EVIDENCE SYNTHESIS: Platinum-based chemotherapy is the recommended first-line standard therapy for all patients fit to receive either cisplatin or carboplatin. Patients positive for programmed death ligand 1 (PD-L1) and ineligible for cisplatin may receive immunotherapy (atezolizumab or pembrolizumab). In case of nonprogressive disease on platinum-based chemotherapy, subsequent maintenance immunotherapy (avelumab) is recommended. For patients without maintenance therapy, the recommended second-line regimen is immunotherapy (pembrolizumab). Later-line treatment has undergone recent advances: the antibody-drug conjugate enfortumab vedotin demonstrated improved overall survival and the fibroblast growth factor receptor (FGFR) inhibitor erdafitinib appears active in case of FGFR3 alterations. CONCLUSIONS: This 2021 update of the EAU guideline provides detailed and contemporary information on the treatment of metastatic urothelial carcinoma for incorporation into clinical practice. PATIENT SUMMARY: In recent years, several new treatment options have been introduced for patients with metastatic urothelial cancer (including bladder cancer and cancer of the upper urinary tract and urethra). These include immunotherapy and targeted treatments. This updated guideline informs clinicians and patients about optimal tailoring of treatment of affected patients.
- Subjects :
- Male
2748 Urology
medicine.medical_specialty
Metastatic Urothelial Carcinoma
Urology
610 Medicine & health
Pembrolizumab
Avelumab
Maintenance therapy
Atezolizumab
Urological cancers Radboud Institute for Molecular Life Sciences [Radboudumc 15]
medicine
Humans
Carcinoma, Transitional Cell
Bladder cancer
business.industry
Guideline
medicine.disease
Regimen
Urinary Bladder Neoplasms
10032 Clinic for Oncology and Hematology
Female
Cisplatin
610 Medizin und Gesundheit
business
medicine.drug
Subjects
Details
- ISSN :
- 03022838
- Volume :
- 81
- Database :
- OpenAIRE
- Journal :
- European Urology
- Accession number :
- edsair.doi.dedup.....aafcdd1b5d953f268b8e13859ba9784b