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DOI: 10.5935/1806-6054.20190003
Year in Review 2018 by LACOG Genitourinary Cancer Group: Urological Tumors
Revisão do ano 2018 pelo grupo de cancer genitourinário do LACOG: Tumores Urológicos Financial support: none to declare.
ABSTRACT
Several and important changes in the treatment of urological tumors occurred in 2018. The studies with apalutamide (SPARTAN) and enzalutamide (PROSPER) prior to the development of metastases benefited patients with castration resistant prostate cancer. Prostate radiotherapy to the metastatic prostate cancer improves overall survival (OS) in men with new diagnosed and with low metastatic disease burden per CHARTEED criteria. In another analysis of this trial, the abiraterone improve OS even in low-risk de novo M1 castration-sensitive prostate cancer. A phase III trial (CARMENA) assessed the utility of cytoreductive nephrectomy in conjunction with TKI's and concluded that we could not offer it in intermediate and poor-risk patients of renal cell carcinoma (RCC). Combined immunotherapy with nivolumab plus ipilimumab (CHECKMATE-214) resulted in a greater objective response rate and prolonged OS in intermediate- and poor-risk patients with metastatic RCC. And in upper tract urothelial cancer, a study showed that adjuvant chemotherapy given after nephroureterectomy improves OS (POUT).
RESUMO
Em 2018, ocorreram várias mudanças importantes no tratamento de tumores urológicos. Estudos com apalutamida (SPARTAN) e enzalutamida (PROSPER) antes do desenvolvimento de metástases beneficiaram pacientes com câncer de próstata resistente à castração. Radioterapia de próstata para câncer de próstata metastático melhora a sobrevida global (SG) em homens recém-diagnosticados e com baixo volume de doença metastática de acordo com os critérios CHARTEED. Em outra análise deste estudo, a abiraterona trouxe ganho de sobrevida mesmo no câncer de próstata sensível à castração M1 de novo e baixo risco. O estudo de fase III, Carmena avaliou a utilidade da nefrectomia citorredutora junto com o TKI e concluiu que poderíamos omití-la aos pacientes de carcinoma de células renais (CCR) de risco pobre e intermédio. A imunoterapia combinada com nivolumab e ipilimumabe (CHECKMATE-214) resultou em uma maior taxa de resposta objetiva e sobrevida global prolongada em pacientes com CCR metastático com risco intermediário e pobre. E no câncer urotelial do trato superior, um estudo mostrou que a quimioterapia adjuvante administrada após nefroureterectomia melhora a SG (POUT).
Keywords:
Review Literature as Topic - Urologic Neoplasms - Prostatic Neoplasms - Urinary Bladder Neoplasms - Kidney NeoplasmsDescritores:
Revisão da Literatura como Tópico - Neoplasias Urológicas - Neoplasias Prostáticas - Neoplasias da Bexiga Urinaria - Neoplasias RenaisPublication History
Received: 13 December 2018
Accepted: 17 March 2019
Article published online:
07 March 2025
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