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IF 2 4区医学 Q3 ONCOLOGY

Oncology Research and Treatment Pub Date : 2025-03-26 DOI:10.1159/000545514

Thomas Hilser, Christopher Darr, Jens Bedke, Philipp Ivanyi, Niklas Klümper, Markus Eckstein, Katrin Schlack, Viktor Grünwald

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引用次数: 0

摘要

背景：尿路上皮癌（UC）是全球重大的健康负担，发病率持续上升。晚期或转移性尿路上皮癌（mUC）的治疗方法不断发展，但在延长生存期方面仍面临巨大挑战：本文基于近期指南的内容和选择性文献检索：过去多年来，顺铂化疗一直是符合条件的患者的标准一线疗法。但单纯化疗的长期疗效有限，而且很大一部分患者要么病情进展迅速，要么因合并症而不符合顺铂治疗条件。这表明了医疗需求，并促使免疫检查点抑制剂（ICI）和抗体药物共轭物（ADC）在mUC治疗领域的发展。最近，ADC的问世进一步扩大了mUC患者的治疗范围，并进一步探索了联合治疗方案。恩福单抗维多汀（EV）和彭博利珠单抗的联合疗法优于标准的铂类化疗，尼夫单抗加吉西他滨加顺铂的联合疗法也是如此，这永久性地改变了mUC的医疗格局。如今，EV 加 pembrolizumab 已成为治疗晚期或 mUC 的一线标准。新的选择也在不断涌现，如针对成纤维细胞生长因子受体（FGFR）的分子疗法。今后，靶向疗法也可用于围手术期：ICI疗法的出现标志着医学治疗的一个里程碑，它提高了UC患者的生存率。EV 联合 pembrolizumab 从根本上改变了这种疾病的医学治疗。这种新型疗法与分子疗法、新型设备和分子标记物相结合，为局部性 UC 的下一步医疗发展提供了巨大的机遇，其临床适用性正在进行中的研究中：如今，EV 联合 pembrolizumab 为 a/mUC 患者的医学治疗树立了新标准。与铂类疗法相比，EV-P的总生存概率提高了一倍，中位OS为31.5个月，这是该疾病姑息治疗的新标志。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Treatment of advanced or metastatic Urothelial Cancer.

Background: Urothelial carcinoma (UC) is a significant global health burden and shows consistent increase in incidence. The treatment landscape for advanced or metastatic urothelial carcinoma (mUC) has evolved, but significant challenges remain to prolong survival.

Methods: The article is based on the content of the recent guidelines and a selective literature search.

Results: For many years in the past, cisplatin-based chemotherapy was the standard first-line therapy for eligible patients. But chemotherapy alone provides limited long-term benefit, and a large proportion of patients either progress rapidly or are ineligible for cisplatin due to comorbidities. This demonstrates the medical need and led to the development of immune checkpoint inhibitors (ICI) and antibody drug conjugates (ADC) in the field of mUC treatment. More recently, the introduction of ADCs further enlarged the medical armentarium in mUC patients and was further explored as combined regimens. The combination of enfortumab vedotin (EV) and pembrolizumab was superior to standard platin-based chemotherapy as did nivolumab plus gemcitabine with cisplatin, which permanently transformed the medical treatment landscape in mUC. Today, EV plus pembrolizumab is the first line standard in treatment of therapeutic advanced or mUC. New options are also emerging, such as molecular therapies that target the fibroblast growth factor receptor (FGFR). In the future, targeted therapy could also be used in the perioperative area.

Conclusion: The advent of ICI therapies marked a milestone in medical treatment, which improved survival in UC patients. EV combined with pembrolizumab has fundamentally changed the medical treatment of this disease. This novel therapy in combination with molecular therapies, novel devices and molecular markers offers a great opportunity for the next step in medical development in localized UC and its clinical applicability is being investigated in ongoing studies Key message: Today, EV combined with pembrolizumab sets a new standard of care in medical treatment of a/mUC patients. Compared to platinum-based therapy, EV-P doubled the overall survival probability and reported a median OS of 31.5 months, which is a new hallmark of palliative medical treatment in this disease.

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来源期刊

Oncology Research and Treatment ONCOLOGY-

CiteScore

3.20

自引率

0.00%

发文量

期刊介绍： With the first issue in 2014, the journal ''Onkologie'' has changed its title to ''Oncology Research and Treatment''. By this change, publisher and editor set the scene for the further development of this interdisciplinary journal. The English title makes it clear that the articles are published in English – a logical step for the journal, which is listed in all relevant international databases. For excellent manuscripts, a ''Fast Track'' was introduced: The review is carried out within 2 weeks; after acceptance the papers are published online within 14 days and immediately released as ''Editor’s Choice'' to provide the authors with maximum visibility of their results. Interesting case reports are published in the section ''Novel Insights from Clinical Practice'' which clearly highlights the scientific advances which the report presents.