Systemtherapie des Harnblasenkarzinoms

Eine Systemtherapie sollte bei geeigneten Patienten integraler Bestandteil der Behandlung des Harnblasenkarzinoms sein. Dieser Beitrag gibt eine Übersicht über die aktuellen Empfehlungen in der Erst- und Zweitlinie.

• Literatur

• 1 Madersbacher S, Hochreiter W, Burkhard F. et al. Radical cystectomy for bladder cancer today – a homogeneous series without neoadjuvant therapy. J Clin Oncol 2003; 21: 690-696
• 2 Hautmann RE, Gschwend JE, de Petriconi RC. et al. Cystectomy for transitional cell carcinoma of the bladder: results of a surgery only series in the neobladder era. J Urol 2006; 176: 486-492
• 3 Leow JJ, Martin-Doyle W, Fay AP. et al. A systematic review and meta-analysis of adjuvant and neoadjuvant chemotherapy for upper tract urothelial carcinoma. Eur Urol 2014; 66: 529-541
• 4 Seiler R, Ashab HAD, Erho N. et al. Impact of Molecular Subtypes in Muscle-invasive Bladder Cancer on Predicting Response and Survival after Neoadjuvant Chemotherapy. Eur Urol 2017; 72: 544-554
• 5 S3-Leitlinie Früherkennung, Diagnose, Therapie und Nachsorge des Harnblasenkarzinoms, Langversion 1.1, AWMF-Registernummer: 032/038OL. Stand November 2016 www.awmf.org/uploads/tx_szleitlinien/032-038ol_l_S3_Harnblasenkarzinom_2016-12.pdf
• 6 Sternberg CN, de Mulder PH, Schornagel JH. et al. Randomized phase III trial of high-dose-intensity methotrexate, vinblastine, doxorubicin, and cisplatin (MVAC) chemotherapy and recombinant human granulocyte colony-stimulating factor versus classic MVAC in advanced urothelial tract tumors. J Clin Oncol 2001; 19: 2638-2646
• 7 von der Maase H, Hansen SW, Roberts JT. et al. Gemcitabine and cisplatin versus methotrexate, vinblastine, doxorubicin, and cisplatin in advanced or metastatic bladder cancer: results of a large, randomized, multinational, multicenter, phase III study. J Clin Oncol 2000; 18: 3068-3077
• 8 Galsky MD, Hahn NM, Rosenberg J. et al. Treatment of patients with metastatic urothelial cancer „unfit“ for Cisplatin-based chemotherapy. J Clin Oncol 2011; 29: 2432-2438
• 9 Niegisch G, Gerullis H, Lin SW. et al. A Real-World Data Study to Evaluate Treatment Patterns, Clinical Characteristics and Survival Outcomes for First- and Second-Line Treatment in Locally Advanced and Metastatic Urothelial Cancer Patients in Germany. J Cancer 2018; 9: 1337-1348
• 10 De Santis M, Bellmunt J, Mead G. et al. Randomized phase II/III trial assessing gemcitabine/carboplatin and methotrexate/carboplatin/vinblastine in patients with advanced urothelial cancer who are unfit for cisplatin-based chemotherapy: EORTC study 30986. J Clin Oncol 2012; 30: 191-199
• 11 Grimm MO. Immunooncology in Urologic Cancers: Current Status. Akt Urol 2016; 47: 374-377
• 12 Balar AV, Galsky MD, Rosenberg JE. et al. Atezolizumab as first-line treatment in cisplatin-ineligible patients with locally advanced and metastatic urothelial carcinoma: a single-arm, multicentre, phase 2 trial. Lancet 2017; 389: 67-76
• 13 Balar AV, Castellano D, O’Donnell PH. et al. First-line pembrolizumab in cisplatin-ineligible patients with locally advanced and unresectable or metastatic urothelial cancer (KEYNOTE-052): a multicentre, single-arm, phase 2 study. Lancet Oncol 2017; 18: 1483-1492
• 14 Bellmunt J, de Wit R, Vaughn DJ. et al. Pembrolizumab as Second-Line Therapy for Advanced Urothelial Carcinoma. N Engl J Med 2017; 376: 1015-1026
• 15 Rosenberg JE, Hoffman-Censits J, Powles T. et al. Atezolizumab in patients with locally advanced and metastatic urothelial carcinoma who have progressed following treatment with platinum-based chemotherapy: a single-arm, multicentre, phase 2 trial. Lancet 2016; 387: 1909-1920
• 16 Sharma P, Retz M, Siefker-Radtke A. et al. Nivolumab in metastatic urothelial carcinoma after platinum therapy (CheckMate 275): a multicentre, single-arm, phase 2 trial. Lancet Oncol 2017; 18: 312-322
• 17 Powles T, Duran I, van der Heijden MS. et al. Atezolizumab versus chemotherapy in patients with platinum-treated locally advanced or metastatic urothelial carcinoma (IMvigor211): a multicentre, open-label, phase 3 randomised controlled trial. Lancet 2018; 391: 748-757
• 18 Bellmunt J, Theodore C, Demkov T. et al. Phase III trial of vinflunine plus best supportive care compared with best supportive care alone after a platinum-containing regimen in patients with advanced transitional cell carcinoma of the urothelial tract. J Clin Oncol 2009; 27: 4454-4461
• 19 Lam JM, Liu WK, Powles T. et al. Single-centre Experience of Patients with Metastatic Urothelial Cancer Treated with Chemotherapy Following Immune Checkpoint Inhibition. Eur Urol Oncol 2019;
• 20 TCGA. Comprehensive molecular characterization of urothelial bladder carcinoma. Nature 2014; 507: 315-322