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The Challenge of Managing Bladder Cancer and Upper Tract Urothelial Carcinoma: A Review with Treatment Recommendations from the Spanish Oncology Genitourinary Group (SOGUG)

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Abstract

Bladder cancer is the fourth most common cancer in men and the ninth most common in women in the Western world. The management of bladder carcinoma requires a multidisciplinary approach. Optimal treatment depends on several factors, including histology, stage, patient status, and possible comorbidities. Here we review recent findings on the treatment of muscle-invasive bladder carcinoma, advanced urothelial carcinoma, upper tract urothelial carcinoma, non-urothelial carcinoma, and urologic complications arising from the disease or treatment. In addition, we present the recommendations of the Spanish Oncology Genitourinary Group for the treatment of these diseases, based on a focused analysis of clinical management and the potential of current research, including recent findings on the potential benefit of immunotherapy. In recent years, whole-genome approaches have provided new predictive biomarkers and promising molecular targets that could lead to precision medicine in bladder cancer. Moreover, the involvement of other specialists in addition to urologists will ensure not only appropriate therapeutic decisions but also adequate follow-up for response evaluation and management of complications. It is crucial, however, to apply recent molecular findings and implement clinical guidelines as soon as possible in order to maximize therapeutic gains and improve patient prognosis.

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Acknowledgements

The authors thank Dr. Joaquin Bellmunt (Bladder Cancer Center, Gelb Center, Dana-Farber/Brigham and Women’s Cancer Center and Harvard Medical School) for his invaluable guidance and comments on previous versions of this article and Ms. Renée Grupp for her assistance in drafting the manuscript.

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Authors and Affiliations

  1. Medical Oncology Service, B-ARGO Group, Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Ctra Canyet, s/n, 08916, Badalona, Spain

    Albert Font

  2. Medical Oncology Service, H.U. Virgen de las Nieves, Granada, Spain

    Raquel Luque

  3. Medical Oncology Service, Hospital General Universitario Ciudad Real, Ciudad Real, Spain

    José Carlos Villa

  4. Medical Oncology Service, Hospital Fundació Althaia, Manresa, Spain

    Montse Domenech

  5. Medical Oncology Service, Hospital Universitario Lucus Augusti, EOXI de Lugo, Cervo e Monforte, Spain

    Sergio Vázquez

  6. Oncology Department, Parc Taulí Hospital Universitari, Institut d’Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain

    Enrique Gallardo

  7. Medical Oncology Service, Hospital Virgen de la Macarena, Seville, Spain

    Juan Antonio Virizuela & Carmen Beato

  8. Medical Oncology Service, Hospital Universitario Vall d’Hebron, Vall d’Hebron Institute of Oncology (VHIO), Universitat Autònoma de Barcelona, Barcelona, Spain

    Rafael Morales-Barrera

  9. Urology Department, Hospital del Mar, Barcelona, Spain

    Antoni Gelabert

  10. Medical Oncology Department, CRO Pivotal, Madrid, Spain

    Sonia Maciá

  11. Medical Oncology Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), CIBERONC, Madrid, Spain

    Javier Puente

  12. Medical Oncology Service, Hospital Universitario Fundación Jimenez Diaz, Madrid, Spain

    Gustavo Rubio

  13. Radiation Oncology Service, Hospital Universitario Vall d’Hebron, Barcelona, Spain

    Xavier Maldonado

  14. Medical Oncology Service, Hospital Universitario Virgen del Rocio, Seville, Spain

    Begoña Perez-Valderrama

  15. Medical Oncology Service, Hospital Universitario La Paz, Madrid, Spain

    Alvaro Pinto

  16. Medical Oncology Service, Complejo Hospitalario Universitario Ourense, Orense, Spain

    Ovidio Fernández Calvo

  17. Medical Oncology, MD Anderson Cancer Center, Madrid, Spain

    Enrique Grande

  18. Medical Oncology Service, Hospital Arnau de Vilanova, Valencia, Spain

    Javier Garde-Noguera

  19. Medical Oncology Service, Hospital Universitario Nuestra Señora de Valme, Seville, Spain

    Eva Fernández-Parra

  20. Medical Oncology Service, Hospital General Universitario Gregorio Marañon, Madrid, Spain

    José Ángel Arranz

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  1. Albert Font
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  2. Raquel Luque
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  3. José Carlos Villa
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Corresponding author

Correspondence to Albert Font.

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Funding

This study was financed by the Spanish Oncology Genitourinary Group (SOGUG) and received no outside funding.

Conflict of interest

Albert Font reports personal fees and non-financial support from Roche, Sanofi, Janssen, and Bayer and grants from Astra-Zeneca, Pierre-Fabre, and Astellas. Enrique Gallardo has received consulting fees from Roche, BMS and Pfizer. Javier Puente has received honoraria as a consultant on advisory boards from Pfizer, Astellas, Janssen, MSD, Bayer, Roche, BMS, Boehringer, Astra Zeneca, Ipsen, Novartis, Eusa Pharma, Eisai, and Sanofi; and as speaker from Kyowa, Celgene, Lilly, Pierre-Fabre, and Merck. Begoña Perez-Valderrama has received consulting fees or honoraria from BMS, Astellas, Novartis, Pierre-Fabre, Bayer, Roche, Ipsen, and Sanofi. Ovidio Fernandez-Calvo has received consulting fees or honoraria from Astellas, Pfizer, Novartis, and Roche. Enrique Grande has received honoraria for advisory boards, meetings, and/or lectures from Pfizer, BMS, Ipsen, Roche, Eisai, Eusa Pharma, MSD, Sanofi-Genzyme, Adacap, Novartis, Pierre Fabre, Lexicon, and Celgene; he has also received unrestricted research grants from Pfizer, Astra Zeneca, MTEM/Threshold, Roche, Ipsen, and Lexicon.  José Ángel Arranz has received consulting fees or honoraria from MSD, Jaansen, and BMS and has participated in local advisory boards for MSD, BMS, and Roche. These authors declare that none of these potential conflicts of interest influenced their contribution to this manuscript or the decision to publish. Raquel Luque, José Carlos Villa, Montse Domenech, Sergio Vazquez-Estevez, Juan Antonio Virizuela, Carmen Beato, Rafael Morales-Barrera, Antoni Gelabert, Sonia Maciá-Escalante, Gustavo Rubio, Xavier Maldonado, Alvaro Pinto, Javier Garde-Noguera, and Eva Fernández-Parra declare that they have no conflicts of interest that might be relevant to the contents of this manuscript.

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Font, A., Luque, R., Villa, J.C. et al. The Challenge of Managing Bladder Cancer and Upper Tract Urothelial Carcinoma: A Review with Treatment Recommendations from the Spanish Oncology Genitourinary Group (SOGUG). Targ Oncol 14, 15–32 (2019). https://doi.org/10.1007/s11523-019-00619-7

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