PMID- 33943047
OWN - NLM
STAT- MEDLINE
DCOM- 20220208
LR  - 20240402
IS  - 2466-054X (Electronic)
IS  - 2466-0493 (Print)
IS  - 2466-0493 (Linking)
VI  - 62
IP  - 3
DP  - 2021 May
TI  - Emerging agents for the treatment of metastatic urothelial cancer.
PG  - 243-255
LID - 10.4111/icu.20200597 [doi]
AB  - Over the past few decades, platinum-based combination chemotherapy (PBCC) has 
      been the preferred initial therapy for metastatic urothelial cancer (mUC). 
      However, despite a response rate of approximately 50%, a small proportion of 
      patients with distant metastases may be cured by cisplatin-based combination 
      chemotherapy (CBCC). In addition, up to 50% of patients are not eligible for CBCC 
      due to age or comorbidities. Furthermore, adverse effects from PBCC are a major 
      concern. The emergence of check-point inhibitors (CPIs), particularly those with 
      antibodies directed against programmed cell death 1 protein (PD-1) or its ligand 
      (PD-L1), advanced the treatment of mUC. Avelumab switch-maintenance therapy is 
      recommended in patients with locally advanced or mUC who did not progress on 
      initial PBCC. With the recent advances in tumor molecular biology and the 
      discovery of actionable therapeutic targets, the clinical application of targeted 
      therapy is now being explored for mUC. Erdafitinib, a tyrosine kinase inhibitor 
      of FGFR1-4, has shown positive outcomes in patients with advanced UC with FGFR 
      alterations. Another recent technological development is antibody-drug conjugates 
      (ADCs), which are complex molecules composed of an antibody linked to a 
      biologically active cytotoxic drug (payload) that targets and kills tumor cells 
      while sparing healthy cells. Enfortumab vedotin, a monoclonal antibody targeting 
      nectin-4 conjugated to monomethyl auristatin E, has demonstrated clinically 
      significant efficacy in patients who do not respond to both cytotoxic 
      chemotherapy and CPIs. In this review, we describe switch-maintenance therapies 
      using CPI, various targeted agents, and ADCs that have been investigated for mUC 
      treatment.
CI  - (c) The Korean Urological Association, 2021.
FAU - Kwon, Whi An
AU  - Kwon WA
AUID- ORCID: 0000-0002-7833-5981
AD  - Department of Urology, Myongji Hospital, Hanyang University College of Medicine, 
      Goyang, Korea.
FAU - Seo, Ho Kyung
AU  - Seo HK
AUID- ORCID: 0000-0003-2601-1093
AD  - Department of Urology, Center for Urologic Cancer, Hospital, National Cancer 
      Center, Goyang, Korea.
AD  - Division of Tumor Immunology, Research Institute, National Cancer Center, Goyang, 
      Korea. seohk@ncc.re.kr.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PL  - Korea (South)
TA  - Investig Clin Urol
JT  - Investigative and clinical urology
JID - 101674989
RN  - 0 (Antibodies, Monoclonal, Humanized)
RN  - 0 (Antineoplastic Agents, Immunological)
RN  - 0 (Immunoconjugates)
RN  - 0 (Receptors, Fibroblast Growth Factor)
RN  - KXG2PJ551I (avelumab)
SB  - IM
MH  - Antibodies, Monoclonal, Humanized/*therapeutic use
MH  - Antineoplastic Agents, Immunological/*therapeutic use
MH  - Humans
MH  - Immunoconjugates/*therapeutic use
MH  - Receptors, Fibroblast Growth Factor/*antagonists & inhibitors
MH  - Urologic Neoplasms/*drug therapy/*pathology
PMC - PMC8100010
OTO - NOTNLM
OT  - Antibody drug conjugate
OT  - Avelumab
OT  - Bladder cancer
OT  - Fibroblast growth factor receptor
COIS- The authors have nothing to disclose.
EDAT- 2021/05/05 06:00
MHDA- 2022/02/09 06:00
PMCR- 2021/05/01
CRDT- 2021/05/04 08:55
PHST- 2020/12/27 00:00 [received]
PHST- 2021/02/04 00:00 [revised]
PHST- 2021/02/14 00:00 [accepted]
PHST- 2021/05/04 08:55 [entrez]
PHST- 2021/05/05 06:00 [pubmed]
PHST- 2022/02/09 06:00 [medline]
PHST- 2021/05/01 00:00 [pmc-release]
AID - 62.243 [pii]
AID - 10.4111/icu.20200597 [doi]
PST - ppublish
SO  - Investig Clin Urol. 2021 May;62(3):243-255. doi: 10.4111/icu.20200597.