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01-09-2017 | Invited Review

Perioperative chemotherapy in upper tract urothelial carcinoma: a comprehensive review

Authors: Atiqullah Aziz, Jakub Dobruch, Kees Hendricksen, Luis A. Kluth, Andrea Necchi, Aidan Noon, Michael Rink, Florian Roghmann, Roland Seiler, Paolo Gontero, Wassim Kassouf, Shahrokh F. Shariat, Evanguelos Xylinas, For the Young Academic Urologists Urothelial Carcinoma Group of the European Association of Urology

Published in: World Journal of Urology | Issue 9/2017

Abstract

Purpose

To evaluate the role of neoadjuvant (NAC) and adjuvant chemotherapy (AC) in patients with upper tract urothelial carcinoma (UTUC) treated with radical nephroureterectomy (RNU).

Methods

A comprehensive review of the current literature was performed searching for all studies investigating NAC and AC in UTUC in MEDLINE and https://clinicaltrials.gov, prior to April 2016. The following keywords were used: “ureteral neoplasms,” “urothelium,” “ureter,” “upper tract urothelial,” “chemotherapy,” “adjuvant,” “neoadjuvant” and relevant variants.

Results

No randomized trials investigated the role of AC or NAC for UTUC. There was one prospective study with n = 36 patients investigating AC with carboplatin–paclitaxel. We included 14 retrospective studies (four in the NAC and ten in the AC setting), with a total of 694 patients receiving cisplatin-based or non-cisplatin-based AC after RNU and 1437 patients undergoing RNU alone. We found that the current literature, mainly based on retrospective studies, suggests significant overall and cancer-specific survival benefits for AC in UTUC. NAC appears promising, with favorable pathologic response rates up to 14%.

Conclusions

Evidence is scarce for both NAC and AC use in UTUC. This comprehensive review suggests promising response rates for NAC and a survival benefit for patients treated with AC. Prospective randomized trials are needed to establish the role of AC and NAC in UTUC.

Roupret M, Babjuk M, Comperat E et al (2013) European guidelines on upper tract urothelial carcinomas: 2013 update. Eur Urol 63:1059–1071CrossRefPubMed

Margulis V, Shariat SF, Matin SF et al (2009) Outcomes of radical nephroureterectomy: a series from the Upper Tract Urothelial Carcinoma Collaboration. Cancer 115:1224–1233CrossRefPubMed

Kondo T, Nakazawa H, Ito F, Hashimoto Y, Toma H, Tanabe K (2007) Primary site and incidence of lymph node metastases in urothelial carcinoma of upper urinary tract. Urology 69:265–269CrossRefPubMed

Advanced Bladder Cancer Meta-analysis C (2005) Neoadjuvant chemotherapy in invasive bladder cancer: update of a systematic review and meta-analysis of individual patient data advanced bladder cancer (ABC) meta-analysis collaboration. Eur Urol 48:202–205 (discussion 05-6) CrossRef

Leow JJ, Martin-Doyle W, Rajagopal PS et al (2014) Adjuvant chemotherapy for invasive bladder cancer: a 2013 updated systematic review and meta-analysis of randomized trials. Eur Urol 66:42–54CrossRefPubMed

Leow JJ, Martin-Doyle W, Fay AP, Choueiri TK, Chang SL, Bellmunt J (2014) A systematic review and meta-analysis of adjuvant and neoadjuvant chemotherapy for upper tract urothelial carcinoma. Eur Urol 66:529–541CrossRefPubMed

Bellmunt J, Petrylak DP (2012) New therapeutic challenges in advanced bladder cancer. Semin Oncol 39:598–607CrossRefPubMed

van Oers JM, Zwarthoff EC, Rehman I et al (2009) FGFR3 mutations indicate better survival in invasive upper urinary tract and bladder tumours. Eur Urol 55:650–657CrossRefPubMed

Kaag MG, O’Malley RL, O’Malley P et al (2010) Changes in renal function following nephroureterectomy may affect the use of perioperative chemotherapy. Eur Urol 58:581–587CrossRefPubMedPubMedCentral

10.

Xylinas E, Rink M, Margulis V et al (2013) Impact of renal function on eligibility for chemotherapy and survival in patients who have undergone radical nephro-ureterectomy. BJU Int 112:453–461CrossRefPubMed

11.

Cordier J, Sonpavde G, Stief CG, Tilki D (2013) Oncologic outcomes obtained after neoadjuvant and adjuvant chemotherapy for the treatment of urothelial carcinomas of the upper urinary tract: a review. World J Urol 31:77–82CrossRefPubMed

12.

Stenzl A, Cowan NC, De Santis M et al (2011) Treatment of muscle-invasive and metastatic bladder cancer: update of the EAU guidelines. Eur Urol 59:1009–1018CrossRefPubMed

13.

Audenet F, Yates DR, Cussenot O, Roupret M (2013) The role of chemotherapy in the treatment of urothelial cell carcinoma of the upper urinary tract (UUT-UCC). Urol Oncol 31:407–413CrossRefPubMed

14.

Gayed BA, Thoreson GR, Margulis V (2013) The role of systemic chemotherapy in management of upper tract urothelial cancer. Curr Urol Rep 14:94–101CrossRefPubMed

15.

Waldert M, Karakiewicz PI, Raman JD et al (2010) A delay in radical nephroureterectomy can lead to upstaging. BJU Int 105:812–817CrossRefPubMed

16.

Igawa M, Urakami S, Shiina H et al (1995) Neoadjuvant chemotherapy for locally advanced urothelial cancer of the upper urinary tract. Urol Int 55:74–77CrossRefPubMed

17.

Matin SF, Margulis V, Kamat A et al (2010) Incidence of downstaging and complete remission after neoadjuvant chemotherapy for high-risk upper tract transitional cell carcinoma. Cancer 116:3127–3134CrossRefPubMed

18.

Porten S, Siefker-Radtke AO, Xiao L et al (2014) Neoadjuvant chemotherapy improves survival of patients with upper tract urothelial carcinoma. Cancer 120:1794–1799CrossRefPubMedPubMedCentral

19.

Youssef RF, Shariat SF, Lotan Y et al (2011) Upper urinary tract urothelial carcinoma with loco-regional nodal metastases: insights from the Upper Tract Urothelial Carcinoma Collaboration. BJU Int 108:1286–1291CrossRefPubMed

20.

Gray PJ, Lin CC, Jemal A et al (2014) Clinical–pathologic stage discrepancy in bladder cancer patients treated with radical cystectomy: results from the national cancer data base. Int J Radiat Oncol Biol Phys 88:1048–1056CrossRefPubMed

21.

Bamias A, Deliveliotis C, Fountzilas G et al (2004) Adjuvant chemotherapy with paclitaxel and carboplatin in patients with advanced carcinoma of the upper urinary tract: a study by the Hellenic Cooperative Oncology Group. J Clin Oncol 22:2150–2154CrossRefPubMed

22.

Hellenthal NJ, Shariat SF, Margulis V et al (2009) Adjuvant chemotherapy for high risk upper tract urothelial carcinoma: results from the Upper Tract Urothelial Carcinoma Collaboration. J Urol 182:900–906CrossRefPubMed

23.

Kawashima A, Nakai Y, Nakayama M et al (2012) The result of adjuvant chemotherapy for localized pT3 upper urinary tract carcinoma in a multi-institutional study. World J Urol 30:701–706CrossRefPubMed

24.

Kim TS, Oh JH, Rhew HY (2013) The efficacy of adjuvant chemotherapy for locally advanced upper tract urothelial cell carcinoma. J Cancer 4:686–690CrossRefPubMedPubMedCentral

25.

Kwak C, Lee SE, Jeong IG, Ku JH (2006) Adjuvant systemic chemotherapy in the treatment of patients with invasive transitional cell carcinoma of the upper urinary tract. Urology 68:53–57CrossRefPubMed

26.

Lee SE, Byun SS, Park YH, Chang IH, Kim YJ, Hong SK (2006) Adjuvant chemotherapy in the management of pT3N0M0 transitional cell carcinoma of the upper urinary tract. Urol Int 77:22–26CrossRefPubMed

27.

Shirotake S, Kikuchi E, Tanaka N et al (2015) Impact of an adjuvant chemotherapeutic regimen on the clinical outcome in high risk patients with upper tract urothelial carcinoma: a Japanese multi-institution experience. J Urol 193:1122–1128CrossRefPubMed

28.

Soga N, Arima K, Sugimura Y (2008) Adjuvant methotrexate, vinblastine, adriamycin, and cisplatin chemotherapy has potential to prevent recurrence of bladder tumors after surgical removal of upper urinary tract transitional cell carcinoma. Int J Urol 15:800–803CrossRefPubMed

29.

Vassilakopoulou M, de la Motte Rouge T, Colin P et al (2011) Outcomes after adjuvant chemotherapy in the treatment of high-risk urothelial carcinoma of the upper urinary tract (UUT-UC): results from a large multicenter collaborative study. Cancer 117:5500–5508CrossRefPubMed

30.

Yafi FA, Tanguay S, Rendon R et al (2014) Adjuvant chemotherapy for upper-tract urothelial carcinoma treated with nephroureterectomy: assessment of adequate renal function and influence on outcome. Urol Oncol 32:31.e17–31.e24CrossRef

31.

Lucca I, Kassouf W, Kapoor A et al (2015) The role of adjuvant chemotherapy for lymph node-positive upper tract urothelial carcinoma following radical nephroureterectomy: a retrospective study. BJU Int 116:72–78CrossRefPubMed

32.

Birtle AJ, Lewis R, Johnson M, Hall E, Group PTM (2012) Time to define an international standard of postoperative care for resected upper urinary tract transitional cell carcinoma (TCC)—opening of the peri-operative chemotherapy versus surveillance in upper tract urothelial cancer (POUT) Trial. BJU Int 110:919–921CrossRefPubMed

33.

Inman BA, Sebo TJ, Frigola X et al (2007) PD-L1 (B7-H1) expression by urothelial carcinoma of the bladder and BCG-induced granulomata: associations with localized stage progression. Cancer 109:1499–1505CrossRefPubMed

34.

Garon EB, Rizvi NA, Hui R et al (2015) Pembrolizumab for the treatment of non-small-cell lung cancer. N Engl J Med 372:2018–2028CrossRefPubMed

35.

Robert C, Long GV, Brady B et al (2015) Nivolumab in previously untreated melanoma without BRAF mutation. N Engl J Med 372:320–330CrossRefPubMed

36.

Motzer RJ, Escudier B, McDermott DF et al (2015) Nivolumab versus everolimus in advanced renal-cell carcinoma. N Engl J Med 373:1803–1813CrossRefPubMed

37.

Brown JA, Dorfman DM, Ma FR et al (2003) Blockade of programmed death-1 ligands on dendritic cells enhances T cell activation and cytokine production. J Immunol 170:1257–1266CrossRefPubMed

38.

Latchman Y, Wood CR, Chernova T et al (2001) PD-L2 is a second ligand for PD-1 and inhibits T cell activation. Nat Immunol 2:261–268CrossRefPubMed

39.

Rosenberg JE, Hoffman-Censits J, Powles T et al (2016) Atezolizumab in patients with locally advanced and metastatic urothelial carcinoma who have progressed following treatment with platinum-based chemotherapy: a single-arm, multicentre, phase 2 trial. Lancet 387:1909–1920CrossRefPubMedPubMedCentral

Title: Perioperative chemotherapy in upper tract urothelial carcinoma: a comprehensive review
Authors: Atiqullah Aziz
Jakub Dobruch
Kees Hendricksen
Luis A. Kluth
Andrea Necchi
Aidan Noon
Michael Rink
Florian Roghmann
Roland Seiler
Paolo Gontero
Wassim Kassouf
Shahrokh F. Shariat
Evanguelos Xylinas
For the Young Academic Urologists Urothelial Carcinoma Group of the European Association of Urology
Publication date: 01-09-2017
Publisher: Springer Berlin Heidelberg
Published in: World Journal of Urology / Issue 9/2017
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-016-1995-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Perioperative chemotherapy in upper tract urothelial carcinoma: a comprehensive review

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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