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Novel Therapeutic Opportunities in Neoadjuvant Setting in Urothelial Cancers: A New Horizon Opened by Molecular Classification and Immune Checkpoint Inhibitors
| Content Provider | MDPI |
|---|---|
| Author | Iacovino, Maria Lucia Miceli, Chiara Carmen Felice, Marco De Barone, Biagio Pompella, Luca Chiancone, Francesco Zazzo, Erika Di Tirino, Giuseppe Corte, Carminia Maria Della Imbimbo, Ciro Vita, Ferdinando De Crocetto, Felice |
| Copyright Year | 2022 |
| Description | Muscle invasive bladder cancer (MIBC) is a widespread malignancy with a worse prognosis often related to a late diagnosis. For early-stage MIBC pts, a multidisciplinary approach is mandatory to evaluate the timing of neoadjuvant chemotherapy (NAC) and surgery. The current standard therapy is platinum-based NAC (MVAC-methotrexate, vinblastine, doxorubicin, and cisplatin or Platinum–Gemcitabine regimens) followed by radical cystectomy (RC) with lymphadenectomy. However, preliminary data from Vesper trial highlighted that dose-dense NAC MVAC is endowed with a good pathological response but shows low tolerability. In the last few years, translational-based research approaches have identified several candidate biomarkers of NAC esponsiveness, such as ERCC2, ERBB2, or DNA damage response (DDR) gene alterations. Moreover, the recent consensus MIBC molecular classification identified six molecular subtypes, characterized by different sensitivity to chemo- or targeted or immunotherapy, that could open a novel procedure for patient selection and also for neoadjuvant therapies. The Italian PURE-01 phase II Trial extended data on efficacy and resistance to Immune Checkpoint Inhibitors (ICIs) in this setting. In this review, we summarize the most relevant literature data supporting NAC use in MIBC, focusing on novel therapeutic strategies such as immunotherapy, considering the better patient stratification and selection emerging from novel molecular classification. |
| Starting Page | 1133 |
| e-ISSN | 14220067 |
| DOI | 10.3390/ijms23031133 |
| Journal | International Journal of Molecular Sciences |
| Issue Number | 3 |
| Volume Number | 23 |
| Language | English |
| Publisher | MDPI |
| Publisher Date | 2022-01-20 |
| Access Restriction | Open |
| Subject Keyword | International Journal of Molecular Sciences Urology and Nephrology Bladder Cancer Urothelial Cancers Neoadjuvant Chemotherapy Immune Checkpoint Inhibitors Molecular Classification of Muscle-invasive Bladder Cancer Muscle-invasive Bladder Cancer |
| Content Type | Text |
| Resource Type | Article |
