title: Management of advanced bladder cancer in the era of targeted therapies.
abstract: Systemic chemotherapy is the standard treatment of advanced and metastatic urothelial carcinoma of the bladder (UCB). Unfortunately, systemic chemotherapy is ineffective in a significant number of patients, while side effects occur frequently. Detailed molecular-genetic investigations revealed a broad heterogeneity of underlying genomic mutations in UCB and led to the detection of cancer-specific therapeutic targets. These findings may allow a more tailored and individualized patient-based therapy, focusing on specific genomic variations, which may cause chemo-resistance in patients progressing or relapsing after standard chemotherapy. Targeted therapies hold the potential to be more effective in inhibiting cancer cell growth and progression, as well as to cause fewer side effects. While targeted therapies have been successfully established in the treatment of various malignancies including renal cell carcinoma, the clinical impact of these modern treatment strategies still remains unsettled for UCB. In this review, we comprehensively summarize the most current and relevant findings on targeted therapy in advanced and metastatic UCB, elucidating chances and limitations and discussing future perspectives.
authors.affiliation: Department of Urology, University Medical Center Hamburg‑Eppendorf, Hamburg, Germany - mrink@uke.de.
authors.forename: A
authors.initials: A
authors.lastname: Soave
authors.forename: O
authors.initials: O
authors.lastname: Engel
authors.forename: G
authors.initials: G
authors.lastname: Von Amsberg
authors.forename: A
authors.initials: A
authors.lastname: Becker
authors.forename: R
authors.initials: R
authors.lastname: Dahlem
authors.forename: S F
authors.initials: SF
authors.lastname: Shariat
authors.forename: M
authors.initials: M
authors.lastname: Fisch
authors.forename: M
authors.initials: M
authors.lastname: Rink
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002295:Carcinoma, Transitional Cell / Q000188:drug therapy* / Q000235:genetics*; D017024:Chemotherapy, Adjuvant / Q000379:methods; D002986:Clinical Trials as Topic; D019317:Evidence-Based Medicine; D023281:Genomics; D006801:Humans; D007167:Immunotherapy / Q000379:methods; D058990:Molecular Targeted Therapy / Q000379:methods; D009154:Mutation; D009367:Neoplasm Staging; D011379:Prognosis; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy* / Q000235:genetics*; D042461:Vascular Endothelial Growth Factor A / Q000187:drug effects* / Q000235:genetics
chemical_list: D042461:Vascular Endothelial Growth Factor A