PMID- 30671136
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200930
IS  - 1756-2872 (Print)
IS  - 1756-2880 (Electronic)
IS  - 1756-2872 (Linking)
VI  - 11
DP  - 2019 Jan-Dec
TI  - Contemporary best practice in the management of urothelial carcinomas of the 
      renal pelvis and ureter.
PG  - 1756287218815372
LID - 10.1177/1756287218815372 [doi]
LID - 1756287218815372
AB  - Upper tract urothelial carcinoma (UTUC) accounts for 5% of urothelial carcinomas 
      (UCs), the estimated annual incidence being 1-2 cases per 100,000 inhabitants. 
      Similarly to bladder UC, divergent differentiations and histologic variants 
      confer an adverse risk factor in comparison with pure UTUC. Molecular and genomic 
      characterization studies on UTUC have shown changes occurring at differing 
      frequencies from bladder cancer, with unique molecular and clinical subtypes, 
      potentially with different responses to treatment. Systemic chemotherapy is the 
      standard approach for patients with inoperable locally advanced or metastatic 
      UCs. Although initial response rates are high, the median survival with 
      combination chemotherapy is about 15 months. In first-line chemotherapy several 
      cisplatin-based regimens have been proposed. For patients with advanced UC who 
      progress to first-line treatment, the only product licensed in Europe is 
      vinflunine, a third-generation, semisynthetic, vinca alkaloid. Better response 
      rates (15-60%), with higher toxicity rates and no overall survival (OS) benefit, 
      are generally achieved in multidrug combinations, which often include taxanes and 
      gemcitabine. The US FDA has recently approved five agents targeting the 
      programmed death-1 and programmed death ligand-1 pathway as a second-line therapy 
      in patients with locally advanced or metastatic UC with disease progression 
      during or following platinum-containing chemotherapy. Potential therapeutic 
      targets are present in 69% of tumours analyzed. Specific molecular alterations 
      include those involved in the RTK/Ras/PI(3)K, cell-cycle regulation and 
      chromatin-remodeling pathways, many of them have either targeted therapies 
      approved or under investigation. Angiogenic agents, anti-epidermal growth factor 
      receptor therapy, phosphoinositide 3-kinase (PI3K) and mammalian target of 
      rapamycin (mTOR) pathway inhibitors and immunotherapeutic drugs are being 
      successfully investigated.
FAU - Bianconi, Maristella
AU  - Bianconi M
AD  - Medical Oncology Unit, 'Madonna del Soccorso' Hospital, ASUR Marche AV5, San 
      Benedetto del Tronto, Italy.
FAU - Cimadamore, Alessia
AU  - Cimadamore A
AD  - Section of Pathological Anatomy, Polytechnic University of the Marche Region, 
      School of Medicine, United Hospitals, Ancona, Italy.
FAU - Faloppi, Luca
AU  - Faloppi L
AD  - Medical Oncology Unit, Macerata General Hospital, ASUR Marche AV3, Macerata, 
      Italy Department of Medical Oncology, 'Duilio Casula' Polyclinic, Cagliari State 
      University, Cagliari, Italy.
FAU - Scartozzi, Mario
AU  - Scartozzi M
AD  - Department of Medical Oncology, 'Duilio Casula' Polyclinic, Cagliari State 
      University, Cagliari, Italy.
FAU - Santoni, Matteo
AU  - Santoni M
AD  - Medical Oncology Unit, Macerata General Hospital, ASUR Marche AV3, Macerata, 
      Italy.
FAU - Lopez-Beltran, Antonio
AU  - Lopez-Beltran A
AD  - Department of Surgery, Cordoba University Medical School, Cordoba, Spain.
FAU - Cheng, Liang
AU  - Cheng L
AD  - Department of Pathology and Laboratory Medicine, Indiana University School of 
      Medicine, Indianapolis, IN, USA.
FAU - Scarpelli, Marina
AU  - Scarpelli M
AD  - Section of Pathological Anatomy, Polytechnic University of the Marche Region, 
      School of Medicine, United Hospitals, Ancona, Italy.
FAU - Montironi, Rodolfo
AU  - Montironi R
AUID- ORCID: 0000-0003-3938-610X
AD  - Section of Pathological Anatomy, Pathological Anatomy, Polytechnic University of 
      the Marche Region, School of Medicine, United Hospitals, Via Conca 71, Ancona, 
      Marche, I-60126, Italy.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20190108
PL  - England
TA  - Ther Adv Urol
JT  - Therapeutic advances in urology
JID - 101487328
PMC - PMC6329040
OTO - NOTNLM
OT  - antiangiogenic agents
OT  - chemotherapy
OT  - gene expression profiling
OT  - immunotherapy
OT  - target therapies
OT  - upper urinary tract
OT  - urothelial carcinoma
COIS- Conflict of interest statement: The authors declare that the research was 
      conducted in the absence of any commercial or financial relationships that could 
      be construed as a potential conflict of interest.
EDAT- 2019/01/24 06:00
MHDA- 2019/01/24 06:01
PMCR- 2019/01/08
CRDT- 2019/01/24 06:00
PHST- 2018/07/16 00:00 [received]
PHST- 2018/11/05 00:00 [accepted]
PHST- 2019/01/24 06:00 [entrez]
PHST- 2019/01/24 06:00 [pubmed]
PHST- 2019/01/24 06:01 [medline]
PHST- 2019/01/08 00:00 [pmc-release]
AID - 10.1177_1756287218815372 [pii]
AID - 10.1177/1756287218815372 [doi]
PST - epublish
SO  - Ther Adv Urol. 2019 Jan 8;11:1756287218815372. doi: 10.1177/1756287218815372. 
      eCollection 2019 Jan-Dec.