passage-241
abstract
Systemic therapy for unresectable and metastatic transitional cell carcinoma of the urothelium: first-line and beyond.  PURPOSE OF REVIEW: The review aims to provide an overview of recent advances and future research direction in the management of patients with advanced transitional cell carcinoma. RECENT FINDINGS: Early data of the randomized phase III study comparing paclitaxel, cisplatin, and gemcitabine with gemcitabine plus cisplatin for advanced urothelial cancer detected no survival difference. A phase II study investigated the safety and efficacy of trastuzumab, carboplatin, gemcitabine, and paclitaxel in human epidermal growth factor receptor-2/neu-positive advanced urothelial carcinoma and reported promising results. Renal-sparing regimens are under active development. A nonrandomized comparison of the 3-week with the 4-week schedule for gemcitabine and cisplatin showed that the 3-week schedule had less hematological toxicity and better dose intensity. Potential molecular markers such as excision repair cross-complementation group 1, emmprin, and survivin for survival and/or platinum resistance in patients with transitional cell carcinoma showed promise. SUMMARY: Recent data do not support change in the current standard of care for advanced transitional cell carcinoma. Clinical testing of emerging anticancer therapies using new agents, new combinations, and new approaches is under active investigation. Rational combination and new strategy in clinical trial design are critical for new drug development for transitional cell carcinoma.
entity-241-0
DISEASE
metastatic transitional cell carcinoma of the urothelium
entity-241-1
DISEASE
transitional cell carcinoma
entity-241-2
DISEASE
urothelial cancer
entity-241-3
DISEASE
urothelial carcinoma
entity-241-4
ADVERSE
hematological toxicity
entity-241-5
DISEASE
transitional cell carcinoma
entity-241-6
DISEASE
transitional cell carcinoma
entity-241-7
DISEASE
transitional cell carcinoma