Recent advances in genitourinary tumors: A review focused on biology and systemic treatment
Por:
del Alba, AG, Arranz, JA, Puente, J, Mendez-Vidal, MJ, Gallardo, E, Grande, E, Perez-Valderrama, B, Gonzalez-Billalabeitia, E, Lazaro-Quintela, M, Pinto, A, Lainez, N, Piulats, JM, Esteban, E, Rey, JPM, Garcia, JA, Suarez, C
Publicada:
1 may 2017
Resumen:
Updated information published up to 2016 regarding major advances in renal cancer, bladder cancer, and prostate cancer is here presented. Based on an ever better understanding of the genetic and molecular alterations that govern the initial pathogenic mechanisms of tumor oncogenesis, an improvement in the characterization and treatment of urologic tumors has been achieved in the past year. According to the Cancer Genome Atlas (ATLAS) project, alterations in the MET pathway are characteristics of type 1 papillary renal cell carcinomas, and activation of NRF2-ARE pathway is associated with the biologically distinct type 2. While sunitinib and pazopanib continue to be the standard first-line treatment in metastatic renal cell carcinoma of clear cell histology, nivolumab and cabozantinib are now the agents of choice in the second-line setting. In relation to urothelial bladder carcinoma, new potential molecular targets such as FGFR3, P13 K/AKT, RTK/RAS, GDKN2A,ARIDIA, ERBB2 have been identified. Response to adjuvant cisplatin-based chemotherapy appears to be related to basal, luminal, and p53-like intrinsic subtypes. A phase II study with eribulin and a maintenance phase II trial with vinflunine have shown promising results. Similarly, the use of the check point inhibitors in advanced disease is likely to revolutionize the management of patients who have progressed after cisplatin-based chemotherapy. In prostate cancer, seven mutually exclusive molecular subtypes have been identified by the TCGA project. Chemotherapy has been consolidated as a key treatment for castration-sensitive metastatic prostate cancer, and abiraterone, enzalutamide, cabazitaxel, and radium-223 remain standard therapeutic options for men with metastatic castration-resistant prostate cancer. All this progress will undoubtedly contribute to the development of new treatments and therapeutic strategies that will improve the survival and quality of life of our patients. (C) 2017 Elsevier B.V. All rights reserved.
Filiaciones:
del Alba, AG:
Hosp Univ Son Espases, Dept Med Oncol, Palma De Mallorca, Spain
Arranz, JA:
Hosp Gen Univ Gregorio Maranon, Unit Urol & Gynecol Tumors, Med Oncol Dept, Madrid, Spain
Puente, J:
Hosp Univ San Carlos, Med Oncol Dept, Madrid, Spain
Mendez-Vidal, MJ:
Hosp Univ Reina Sofia, Maimonides Inst Med Res IMIBIC, Oncol Dept, Cordoba, Spain
Gallardo, E:
Hosp Univ Parc Tauli, Dept Oncol, Barcelona, Spain
Grande, E:
Hosp Univ Ramon y Cajal, Early Drug Dev Unit IRYCIS, Endocrine & Translat Res Unit, Med Oncol Dept,GI, Madrid, Spain
Perez-Valderrama, B:
Hosp Univ Virgen del Rocio, Oncol Dept, Seville, Spain
Gonzalez-Billalabeitia, E:
Hosp GU Morales Meseguer, Med Oncol & Hematol Dept, Murcia, Spain
Lazaro-Quintela, M:
Complexo Hosp Univ Vigo, Med Oncol Dept, Vigo, Spain
Pinto, A:
Hosp Univ La Paz, Inst Invest Sanitaria Hosp La Paz IdiPAZ, Med Oncol Dept, Madrid, Spain
Lainez, N:
Complejo Hosp Navarra, Med Oncol Dept, Pamplona, Spain
Piulats, JM:
Inst Catala Oncol, Med Oncol Dept, Barcelona, Spain
Esteban, E:
Hosp Univ Cent Asturias, Med Oncol Dept, Oviedo, Spain
Rey, JPM:
Hosp Santa Creu & Sant Pau, Med Oncol Dept, Barcelona, Spain
Garcia, JA:
Cleveland Clin, Hematol Oncol Dept, Cleveland, OH 44106 USA
Cleveland Clin, Urol Dept, Cleveland, OH 44106 USA
Suarez, C:
Univ Autonoma Barcelona, Vall dHebron Univ Hosp, Barcelona, Spain
Univ Autonoma Barcelona, Inst Oncol, Barcelona, Spain
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