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Lewerich J, Schmid SC, Gschwend JE, Retz M. [Value of immunotherapy in the perioperative treatment of localized muscle invasive bladder cancer]. UROLOGIE (HEIDELBERG, GERMANY) 2023; 62:279-287. [PMID: 36449033 PMCID: PMC9998310 DOI: 10.1007/s00120-022-01983-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/17/2022] [Indexed: 12/03/2022]
Abstract
Immune checkpoint inhibitors are standard of care in the treatment of metastatic and locally advanced urothelial cancer. Their use in perioperative treatment is currently under investigation as monotherapy as well as in combination with chemotherapy or radiation regimens. This article provides an overview of recent trials, current data as well as an outlook on future developments in the perioperative management of urothelial cancer.
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Schmid SC, Lewerich J, Retz M, Rödel C. ["Surgery only" is not enough: potential of multimodal therapy in urothelial bladder carcinoma]. UROLOGIE (HEIDELBERG, GERMANY) 2022; 61:1332-1340. [PMID: 36352266 DOI: 10.1007/s00120-022-01963-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/05/2022] [Indexed: 06/16/2023]
Abstract
Radical cystectomy is the standard treatment for muscle invasive bladder cancer. Using perioperative cisplatin-based chemotherapy, 5‑year overall survival rates are 5% higher with neoadjuvant chemotherapy compared to local therapy alone. New multimodal concepts have been developed to improve oncologic efficacy and to reduce treatment-related morbidity. Perioperative use of checkpoint inhibitors aims at improving efficacy, while bladder-preserving concepts try to avoid cystectomy in good responders. This article reviews new developments in radioimmunotherapy and perioperative combination therapies as well as bladder-preserving concepts like trimodal bladder therapy.
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Koshkin V, Powles T, Iyer G, Loriot Y, Drakaki A, Duran Martinez I, De Santis M, Retz M, Jain R, Chan S, Ichimaru M, Galsky M. 1779TiP Phase II clinical study evaluating the efficacy and safety of disitamab vedotin in patients (pts) with HER2-expressing urothelial carcinoma (RC48G001). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Tauber R, Retz M, Knorr K, D’Alessandria C, Grigorascu S, Hansen K, Wester HJ, Gschwend J, Weber W, Eiber M, Langbein T. 1414P Treatment efficacy and safety of 177Lu-PSMA radioligand therapy in octogenarians with metastatic castration-resistant prostate cancer. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Yu E, Park S, Goh J, Shin S, Mehra N, McDermott R, Sala Gonzalez M, Fong P, Greil R, Retz M, Sade J, Huang YH, Begbie S, Rey F, Kramer G, Suzuki H, Zhang J, Kim J, Poehlein C, Antonarakis E. 1362MO Pembrolizumab + olaparib vs abiraterone (abi) or enzalutamide (enza) for patients (pts) with previously treated metastatic castration-resistant prostate cancer (mCRPC): Randomized open-label phase III KEYLYNK-010 study. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Schmid S, Schiller K, Seitz A, Koll F, Beckert F, Korn P, Lewerich J, Maisch P, Sauter A, Rödel C, Flentje M, Riedel T, Combs S, Zengerling F, Bolenz C, Kübler H, Gschwend J, Retz M. RACE IT - A prospective, single arm, multicenter, phase II-trial to assess safety and efficacy of preoperative RAdiation therapy before radical CystEctomy combined with ImmunoTherapy in locally advanced urothelial carcinoma of the bladder (AB 65/18). Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00417-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Petrylak D, Perez-Gracia J, Lacombe L, Bastos D, Mahammedi H, Kwan E, Zschäbitz S, Armstrong A, Pachynski R, Goh J, Burotto M, Gravis G, McCune S, Vázquez Limón J, Retz M, Saad F, Amin N, Li J, Unsal-Kacmaz K, Fizazi K. 579MO CheckMate 9KD cohort A2 final analysis: Nivolumab (NIVO) + rucaparib for chemotherapy (CT)-naïve metastatic castration-resistant prostate cancer (mCRPC). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1092] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Rexer H, Grimm MO, Retz M. Neoadjuvante Therapieschemen kombiniert mit adjuvanter Therapie bei muskelinvasivem Blasenkrebs vor bzw. nach radikaler Zystektomie. Aktuelle Urol 2021; 52:428-429. [PMID: 34428822 DOI: 10.1055/a-1533-7750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Heinzelbecker J, Spieler N, Kühn M, Fischer C, Volkmer B, Von Rundstedt FC, Albers P, Becht E, Bannowsky A, Weber H, Hofmann R, Müller M, Langbein S, Steiner G, Retz M, Kamradt J, Wellek S, Lehmann J, Stöckle M. Adjuvant vs. progression-triggered treatment with gemcitabine after radical cystectomy in platinum-ineligible patients with pT3-pT4 or N+ M0 urothelial carcinoma of the bladder (AUO-AB 22-00): Long-term follow-up of a randomized multicenter phase 3 trial. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01203-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Rexer H, Retz M, Kramer M. Erstlinientherapie beim lokal fortgeschrittenen oder metastasierten Urothelkarzinom. Aktuelle Urol 2021; 52:28-29. [PMID: 33525026 DOI: 10.1055/a-1252-8608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Joshua A, Gurney H, Retz M, Tafreshi A, Fong P, Shore N, Romano E, Augustin M, Piulats J, Berry W, Kolinsky M, Sridhar S, Conter H, Todenhöfer T, Appleman L, Wu H, Schloss C, Poehlein C, de Bono J, Yu E. 217O Pembrolizumab (pembro) combination therapies in patients with metastatic castration-resistant prostate cancer (mCRPC): Cohorts A-C of the phase Ib/II KEYNOTE-365 study. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.10.437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Romano E, Sridhar S, Kolinsky M, Gravis G, Mourey L, Piulats J, Berry W, Gurney H, Retz M, Appleman L, Boegemann M, de Bono J, Joshua A, Emmenegger U, Conter H, Laguerre B, Wu H, Qiu P, Schloss C, Yu E. 620P Pembrolizumab (pembro) plus docetaxel and prednisone in patients with abiraterone acetate (abi)- or enzalutamide (enza)–pretreated metastatic castration-resistant prostate cancer (mCRPC): KEYNOTE-365 cohort B update. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Mourey L, Conter H, Shore N, Berry W, Fong P, Piulats J, Appleman L, Todenhöfer T, Gravis G, Laguerre B, Gurney H, Retz M, Romano E, de Bono J, Kam A, Emmenegger U, Wu H, Qiu P, Schloss C, Yu E. 625P Pembrolizumab (pembro) plus enzalutamide (enza) in patients with abiraterone acetate (abi)-pretreated metastatic castration-resistant prostate cancer (mCRPC): KEYNOTE-365 Cohort C update. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.884] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Gravis G, Kolinsky M, Mourey L, Piulats J, Sridhar S, Romano E, Berry W, Gurney H, Retz M, Appleman L, Boegemann M, De Bono J, Joshua A, Emmenegger U, Conter H, Laguerre B, Wu H, Schloss C, Poehlein C, Yu E. KEYNOTE-365 cohort B updated results: Pembrolizumab (pembro) plus docetaxel and prednisone in abiraterone (abi) or enzalutamide (enza) pre-treated patients with metastatic castration-resistant prostate cancer (mCRPC). EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33163-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Horwich A, Babjuk M, Bellmunt J, Bruins HM, De Reijke TM, De Santis M, Gillessen S, James N, Maclennan S, Palou J, Powles T, Ribal MJ, Shariat SF, Van Der Kwast T, Xylinas E, Agarwal N, Arends T, Bamias A, Birtle A, Black PC, Bochner BH, Bolla M, Boormans JL, Bossi A, Briganti A, Brummelhuis I, Burger M, Castellano D, Cathomas R, Chiti A, Choudhury A, Compérat E, Crabb S, Culine S, De Bari B, DeBlok W, De Visschere PJL, Decaestecker K, Dimitropoulos K, Dominguez-Escrig JL, Fanti S, Fonteyne V, Frydenberg M, Futterer JJ, Gakis G, Geavlete B, Gontero P, Grubmüller B, Hafeez S, Hansel DE, Hartmann A, Hayne D, Henry AM, Hernandez V, Herr H, Herrmann K, Hoskin P, Huguet J, Jereczek-Fossa BA, Jones R, Kamat AM, Khoo V, Kiltie AE, Krege S, Ladoire S, Lara PC, Leliveld A, Linares-Espinós E, Løgager V, Lorch A, Loriot Y, Meijer R, Carmen Mir M, Moschini M, Mostafid H, Müller AC, Müller CR, N'Dow J, Necchi A, Neuzillet Y, Oddens JR, Oldenburg J, Osanto S, Oyen WJG, Pacheco-Figueiredo L, Pappot H, Patel MI, Pieters BR, Plass K, Remzi M, Retz M, Richenberg J, Rink M, Roghmann F, Rosenberg JE, Rouprêt M, Rouvière O, Salembier C, Salminen A, Sargos P, Sengupta S, Sherif A, Smeenk RJ, Smits A, Stenzl A, Thalmann GN, Tombal B, Turkbey B, Vahr Lauridsen S, Valdagni R, Van Der Heijden AG, Van Poppel H, Vartolomei MD, Veskimäe E, Vilaseca A, Vives Rivera FA, Wiegel T, Wiklund P, Williams A, Zigeuner R, Witjes JA. EAU-ESMO consensus statements on the management of advanced and variant bladder cancer-an international collaborative multi-stakeholder effort: under the auspices of the EAU and ESMO Guidelines Committees†. Ann Oncol 2019; 30:1697-1727. [PMID: 31740927 PMCID: PMC7360152 DOI: 10.1093/annonc/mdz296] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Although guidelines exist for advanced and variant bladder cancer management, evidence is limited/conflicting in some areas and the optimal approach remains controversial. OBJECTIVE To bring together a large multidisciplinary group of experts to develop consensus statements on controversial topics in bladder cancer management. DESIGN A steering committee compiled proposed statements regarding advanced and variant bladder cancer management which were assessed by 113 experts in a Delphi survey. Statements not reaching consensus were reviewed; those prioritised were revised by a panel of 45 experts before voting during a consensus conference. SETTING Online Delphi survey and consensus conference. PARTICIPANTS The European Association of Urology (EAU), the European Society for Medical Oncology (ESMO), experts in bladder cancer management. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Statements were ranked by experts according to their level of agreement: 1-3 (disagree), 4-6 (equivocal), 7-9 (agree). A priori (level 1) consensus was defined as ≥70% agreement and ≤15% disagreement, or vice versa. In the Delphi survey, a second analysis was restricted to stakeholder group(s) considered to have adequate expertise relating to each statement (to achieve level 2 consensus). RESULTS AND LIMITATIONS Overall, 116 statements were included in the Delphi survey. Of these, 33 (28%) statements achieved level 1 consensus and 49 (42%) statements achieved level 1 or 2 consensus. At the consensus conference, 22 of 27 (81%) statements achieved consensus. These consensus statements provide further guidance across a broad range of topics, including the management of variant histologies, the role/limitations of prognostic biomarkers in clinical decision making, bladder preservation strategies, modern radiotherapy techniques, the management of oligometastatic disease and the evolving role of checkpoint inhibitor therapy in metastatic disease. CONCLUSIONS These consensus statements provide further guidance on controversial topics in advanced and variant bladder cancer management until a time where further evidence is available to guide our approach.
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Tauber R, Feuerecker B, Knorr K, Beheshti A, Seidl C, D’Alessandria C, Bruchertseifer F, Retz M, Gschwend J, Weber W, Morgenstern A, Eiber M. Safety and efficacy of Ac-225-PSMA-617 in metastatic castration resistant prostate cancer (mCRPC) after failure of Lu-177-PSMA. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz248.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Maisch P, Gschwend JE, Retz M. [Efficacy of a ketogenic diet in urological cancers patients : A systematic review]. Urologe A 2019; 57:307-313. [PMID: 29322234 DOI: 10.1007/s00120-017-0563-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Beside the classical anticancer treatment tumor patients try to find proactive alternative therapies to fight their disease. Lifestyle changes such as introducing a ketogenic diet is one of the most popular among them. The German Association of Urological Oncology (AUO, Arbeitsgemeinschaft Urologische Onkologie) presents a systematic review investigating the evidence of ketogenic diet in cancer patients. MATERIALS AND METHODS A systematic literature research was conducted in the databases Medline, Livivo, and the Cochrane Library. Only clinical studies of tumor patients receiving chemotherapy while on a ketogenic diet were included. The assessment of the results was performed according to the predefined primary endpoints overall survival and progression-free survival and secondary endpoints quality of life and reduction of adverse effects induced by cytostatics. RESULTS Nine studies met the inclusion criteria: eight prospective and one retrospective study case series respectively cohort-studies, with a total of 107 patients. Currently there is no evidence of a therapeutic effect of a ketogenic diet in patients with malignant tumors regarding the clinical outcome or quality of life. CONCLUSION Based on the current data, a ketogenic diet can not be recommended to cancer patients because prospective, randomized trials are missing.
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Rexer H, Retz M, Waller C. Erstlinientherapie beim unbehandelten nicht resektablen oder metastasierten Urothelkarzinom: Eine offene, randomisierte, Phase-III Studie zu Nivolumab in Kombination mit Ipilimumab oder mit Standardchemotherapie gegenüber Standard-Chemotherapie bei Patienten mit bisher unbehandeltem inoperablen oder metastasierten Urothelkarzinom (CheckMate-901) – AB 59/17 der AUO. Aktuelle Urol 2019; 50:20-21. [PMID: 30731500 DOI: 10.1055/a-0790-9608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Tauber R, Knorr K, Schwaiger S, Retz M, Maurer T, D'Alessandria C, Wester HJ, Gschwend J, Weber W, Schwaiger M, Heck M, Eiber M. Clinical experience with 100 consecutive patients treated with Lu-177-labeled PSMA-I&T radioligand therapy for metastatic castration-resistant prostate cancer: Final analysis. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy284.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Bellmunt J, Eigl BJ, Senkus E, Loriot Y, Twardowski P, Castellano D, Blais N, Sridhar SS, Sternberg CN, Retz M, Pal S, Blumenstein B, Jacobs C, Stewart PS, Petrylak DP. Borealis-1: a randomized, first-line, placebo-controlled, phase II study evaluating apatorsen and chemotherapy for patients with advanced urothelial cancer. Ann Oncol 2018; 28:2481-2488. [PMID: 28961845 DOI: 10.1093/annonc/mdx400] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background Five-year survival of patients with inoperable, advanced urothelial carcinoma treated with the first-line chemotherapy is 5%-15%. We assessed whether the Hsp27 inhibitor apatorsen combined with gemcitabine plus cisplatin (GC) could improve overall survival (OS) in these patients. Patients and methods This placebo-controlled, double-blind, phase II trial randomized 183 untreated urothelial carcinoma patients (North America and Europe) to receive GC plus either placebo (N = 62), 600 mg apatorsen (N = 60), or 1000 mg apatorsen (N = 61). In the experimental arm, treatment included loading doses of apatorsen followed by up to six cycles of apatorsen plus GC. Patients receiving at least four cycles could continue apatorsen monotherapy as maintenance until progression or unacceptable toxicity. The primary end point was OS. Results OS was not significantly improved in the single or combined 600- or 1000-mg apatorsen arms versus placebo [hazard ratio (HR), 0.86 and 0.90, respectively]. Exploratory study of specific statistical modeling showed a trend for improved survival in patients with baseline poor prognostic features treated with 600 mg apatorsen compared with placebo (HR = 0.72). Landmark analysis of serum Hsp27 (sHsp27) levels showed a trend toward survival benefit for poor-prognosis patients in 600- and 1000-mg apatorsen arms who achieved lower area under the curve sHsp27 levels, compared with the placebo arm (HR = 0.45 and 0.62, respectively). Higher baseline circulating tumor cells (≥5 cells/7.5 ml) was observed in patients with poor prognosis in correlation with poor survival. Treatment-emergent adverse events were manageable and more common in both apatorsen-treatment arms. Conclusions Even though apatorsen combined with standard chemotherapy did not demonstrate a survival benefit in the overall study population, patients with poor prognostic features might benefit from this combination. Serum Hsp27 levels may act as a biomarker to predict treatment outcome. Further exploration of apatorsen in poor-risk patients is warranted.
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Retz M, Bardenheuer HJ. [Supportive therapy, best supportive care, and palliative medicine]. Urologe A 2018; 57:530-531. [PMID: 29744546 DOI: 10.1007/s00120-018-0640-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Maisch P, Gschwend JE, Retz M. Unzureichende Studienergebnisse und fehlender positiver klinischer Nutzen der ketogenen Diät. Urologe A 2018; 57:607-608. [DOI: 10.1007/s00120-018-0638-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Horn T, Krege S, Retz M. [Advanced bladder cancer : From chemo- to immunotherapy]. Urologe A 2018; 57:686-692. [PMID: 29637216 DOI: 10.1007/s00120-018-0626-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
In November 2016, the results of a phase III clinical trial with the protein cell death (PD)-1 inhibitor pembrolizumab for second-line treatment of metastatic urothelial carcinoma were published and showed an overall survival benefit in comparison with conventional chemotherapy with vinflunine, docetaxel, or paclitaxel. In a similar trial the PD-L1 antibody atezolizumab showed no significant benefit in comparison to chemotherapy in the subgroup of PD-L1-positive patients and, thus, missed its primary endpoint. For other PD-1/PD-L1 directed substances, large phase I/II trials reported data concerning response rates and overall survival. This substance class will most likely become the new treatment standard in second-line treatment of metastatic urothelial cancer. Currently, PD-1/PD-L1 inhibitors are also being tested within randomized phase III trials for first-line treatment using different approaches either as a monotherapy or a combination with conventional chemotherapy or cytotoxic T‑lymphocyte-associated protein (CTLA)-4 inhibitors. Whereas data from single-arm phase II clinical trials have already been published, preliminary phase III data are expected in 2018.
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Heck M, Schwaiger S, Knorr K, Retz M, Maurer T, Janssen F, D`Alessandria C, Wester HJ, Gschwend J, Schwaiger M, Tauber R, Eiber M. Radioligand therapy with Lutetium 177-labeled PSMA-I&T for metastatic castration-resistant prostate cancer: Clinical experience with 100 consecutive patients. ACTA ACUST UNITED AC 2018. [DOI: 10.1016/s1569-9056(18)31442-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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