Re-appraisal of Standard of Care Imaging to Identify Predictors of Treatment Outcomes among Patients with Bladder and Upper Tract Urothelial Cancers.

Purpose of review: Urothelial carcinoma is a prevalent malignancy within the United States that may involve the upper and/or lower urinary tracts. Multimodal treatment is often employed, with transurethral resection and intravesical therapy standard of care for non-muscle-invasive disease; neoadjuvant systemic therapy followed by radical cystectomy or trimodal therapy for muscle-invasive disease; and combination immune checkpoint inhibitors and antibody-drug conjugates standard of care for metastatic disease. These treatments carry risks of surgical complication or treatment-associated toxicity which can impair quality of life. Predictive biomarkers of treatment tolerability are currently limited.

Recent findings: There is emerging evidence that radiological biomarkers can predict treatment outcomes among patients with urothelial carcinoma. In this review, we evaluate the existing data on radiological biomarkers evaluable from current standard-of-care imaging in predicting treatment outcome among patients with urothelial carcinoma.