Urologie pro praxi 3/2023

Treatment of urothelial carcinoma bladder cancer

Treatment of non-muscle-invasive bladder cancer (NMIBC) should follow a risk-stratified approach with transurethral resection (TUR) and intravesical chemotherapy (ChT) or Bacillus Calmette-Guérin vaccine (BCG) in intermediate- and high-risk patients. The use of cisplatin-based neoadjuvant chemotherapy for bladder cancer is supported. Cisplatin-containing combination ChT is standard in advanced or metastatic patients fit enough to tolerate cisplatin. Carboplatin-based ChT is recommended in patients unfit for cisplatin. Pembrolizumab or atezolizumab are alternative choices for patients who are PD-L1-positive and not eligible for cisplatin-based ChT. The first antibody drug conjugate to report encouraging data was enfortumab vedotin. Erdafitinib is a pan-FGFR tyrosine kinase inhibitor and the first U.S. Food and Drug Administration (FDA) approved targeted therapy for metastatic urothelial carcinoma with FGFR2/3 alterations following platinum-containing chemotherapy.

Keywords: urothelial carcinoma bladder cancer, platinum based chemotherapy, immune checkpoint inhibitors, fibroblast growth factor receptor inhibitors, antibody drug conjugates.