Current and Emerging Strategies to Treat Urothelial Carcinoma
Urothelial cell carcinoma (UCC, bladder cancer, BC) remains a difficult-to-treat malignancy with a rising incidence worldwide. In the U.S., UCC is the sixth most incident neoplasm and ~90% of diagnoses are made in those >55 years of age; it is ~four times more commonly observed in men than women....
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-10-01
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| Series: | Cancers |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2072-6694/15/19/4886 |
| _version_ | 1797576027751317504 |
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| author | Berkha Rani James J. Ignatz-Hoover Priyanka S. Rana James J. Driscoll |
| author_facet | Berkha Rani James J. Ignatz-Hoover Priyanka S. Rana James J. Driscoll |
| author_sort | Berkha Rani |
| collection | DOAJ |
| description | Urothelial cell carcinoma (UCC, bladder cancer, BC) remains a difficult-to-treat malignancy with a rising incidence worldwide. In the U.S., UCC is the sixth most incident neoplasm and ~90% of diagnoses are made in those >55 years of age; it is ~four times more commonly observed in men than women. The most important risk factor for developing BC is tobacco smoking, which accounts for ~50% of cases, followed by occupational exposure to aromatic amines and ionizing radiation. The standard of care for advanced UCC includes platinum-based chemotherapy and programmed cell death (PD-1) or programmed cell death ligand 1 (PD-L1) inhibitors, administered as frontline, second-line, or maintenance therapy. UCC remains generally incurable and is associated with intrinsic and acquired drug and immune resistance. UCC is lethal in the metastatic state and characterized by genomic instability, high PD-L1 expression, DNA damage-response mutations, and a high tumor mutational burden. Although immune checkpoint inhibitors (ICIs) achieve long-term durable responses in other cancers, their ability to achieve similar results with metastatic UCC (mUCC) is not as well-defined. Here, we discuss therapies to improve UCC management and how comprehensive tumor profiling can identify actionable biomarkers and eventually fulfill the promise of precision medicine for UCC patients. |
| first_indexed | 2024-03-10T21:47:40Z |
| format | Article |
| id | doaj.art-78079945bb624e70b71dc8e6854a2743 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T21:47:40Z |
| publishDate | 2023-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-78079945bb624e70b71dc8e6854a27432023-11-19T14:11:59ZengMDPI AGCancers2072-66942023-10-011519488610.3390/cancers15194886Current and Emerging Strategies to Treat Urothelial CarcinomaBerkha Rani0James J. Ignatz-Hoover1Priyanka S. Rana2James J. Driscoll3Case Comprehensive Cancer Center, School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USACase Comprehensive Cancer Center, School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USACase Comprehensive Cancer Center, School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USACase Comprehensive Cancer Center, School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USAUrothelial cell carcinoma (UCC, bladder cancer, BC) remains a difficult-to-treat malignancy with a rising incidence worldwide. In the U.S., UCC is the sixth most incident neoplasm and ~90% of diagnoses are made in those >55 years of age; it is ~four times more commonly observed in men than women. The most important risk factor for developing BC is tobacco smoking, which accounts for ~50% of cases, followed by occupational exposure to aromatic amines and ionizing radiation. The standard of care for advanced UCC includes platinum-based chemotherapy and programmed cell death (PD-1) or programmed cell death ligand 1 (PD-L1) inhibitors, administered as frontline, second-line, or maintenance therapy. UCC remains generally incurable and is associated with intrinsic and acquired drug and immune resistance. UCC is lethal in the metastatic state and characterized by genomic instability, high PD-L1 expression, DNA damage-response mutations, and a high tumor mutational burden. Although immune checkpoint inhibitors (ICIs) achieve long-term durable responses in other cancers, their ability to achieve similar results with metastatic UCC (mUCC) is not as well-defined. Here, we discuss therapies to improve UCC management and how comprehensive tumor profiling can identify actionable biomarkers and eventually fulfill the promise of precision medicine for UCC patients.https://www.mdpi.com/2072-6694/15/19/4886antibody-drug conjugatedrug resistanceimmune checkpoint inhibitorsimmunotherapymetastasistumorigenesis |
| spellingShingle | Berkha Rani James J. Ignatz-Hoover Priyanka S. Rana James J. Driscoll Current and Emerging Strategies to Treat Urothelial Carcinoma Cancers antibody-drug conjugate drug resistance immune checkpoint inhibitors immunotherapy metastasis tumorigenesis |
| title | Current and Emerging Strategies to Treat Urothelial Carcinoma |
| title_full | Current and Emerging Strategies to Treat Urothelial Carcinoma |
| title_fullStr | Current and Emerging Strategies to Treat Urothelial Carcinoma |
| title_full_unstemmed | Current and Emerging Strategies to Treat Urothelial Carcinoma |
| title_short | Current and Emerging Strategies to Treat Urothelial Carcinoma |
| title_sort | current and emerging strategies to treat urothelial carcinoma |
| topic | antibody-drug conjugate drug resistance immune checkpoint inhibitors immunotherapy metastasis tumorigenesis |
| url | https://www.mdpi.com/2072-6694/15/19/4886 |
| work_keys_str_mv | AT berkharani currentandemergingstrategiestotreaturothelialcarcinoma AT jamesjignatzhoover currentandemergingstrategiestotreaturothelialcarcinoma AT priyankasrana currentandemergingstrategiestotreaturothelialcarcinoma AT jamesjdriscoll currentandemergingstrategiestotreaturothelialcarcinoma |