Abstract

SANTANA, Diego; JELDRES, Mathias  and  SILVEYRA, Noelia. Metastatic bladder cancer: new treatment standard. Rev. Méd. Urug. [online]. 2024, vol.40, n.4, e401.  Epub Nov 26, 2024. ISSN 0303-3295.  https://doi.org/10.29193/rmu.40.4.9.

Bladder cancer is the most common malignant neoplasm of the urinary system, with a global incidence of half a million cases per year. Muscle-invasive urothelial carcinomas have a ≥50% chance of developing metastasis during their progression. In the last three decades, the treatment of metastatic bladder cancer has been platinum-based chemotherapy. Although initially effective, it fails to produce durable responses, and the median survival is around 15 months. In recent years, several pivotal studies have changed the standard treatment for metastatic bladder cancer through the use of immunotherapy, targeted therapies, antibody-drug conjugates, and combinations of these. At the 2023 European Society for Medical Oncology (ESMO) Congress, two studies were presented that revolutionized the treatment of metastatic urothelial cancer. These studies, published in PubMed (period 2020-April 2024), have led to changes in global oncological treatment guidelines. This article critically reviews these advances, highlighting their impact on patient survival and quality of life, as well as their potential to redefine the therapeutic management of the disease.

Keywords : Metastatic bladder cancer; Metastatic urothelial carcinoma; Treatment; Immune checkpoint inhibitors; PD-1/PD-L1 inhibitors; Antibody-drug conjugates.

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