Systemic Therapy for Advanced Urothelial Carcinoma: Current Standards and Treatment Considerations

Bladder cancer is the sixth most common cancer in the United States, with an estimated 79,030 cases diagnosed in 2017.1,2 Men are four times more likely to develop disease than women, with approximately 60,490 men and 18,540 women diagnosed annually.1,2 Although the majority of cases are non–muscle-invasive malignancy, nearly 70% of these will have a recurrence within 5 years, with 10% to 20% developing advanced muscle-invasive or metastatic disease.3 Despite multidisciplinary therapeutic advances, clinical outcomes remain suboptimal, with 5-year survival rates around 77% for all stages combined and less than 15% for those with metastatic disease.4 Further, urothelial malignancies frequently occur in an older population, many with comorbidities, rendering a large percentage of newly diagnosed patients ineligible to receive standard chemotherapy regimens. Overall outcomes have been rather static for decades, with some recent improvements, yet there remains an unmet need for newer interventions. Here, we first review historic standard chemotherapy regimens, followed by more recent targeted and immunotherapy options for the management of advanced bladder cancer. SYSTEMIC CHEMOTHERAPY IN ADVANCED UROTHELIAL CANCER Section: ChooseTop of pageAbstractSYSTEMIC CHEMOTHERAPY IN ... <