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更新于：2025-05-07

Urothelial carcinoma bladder stage IV

膀胱尿路上皮癌Ⅳ期

更新于：2025-05-07

基本信息

别名

Bladder transitional cell carcinoma stage IV、Stage IV Bladder Urothelial Carcinoma、Stage IV Bladder Urothelial Carcinoma AJCC v7

+ [11]

简介

Stage IV includes: (T4b, N0, M0); (Any T, N1-3, M0); (Any T, Any N, M1). T4b: Tumor invades pelvic wall, abdominal wall. N0: No regional lymph node metastasis. N1: Single regional lymph node metastasis in the true pelvis (hypogastric, obturator, external iliac, or presacral lymph node). N2: Multiple regional lymph node metastases in the true pelvis (hypogastric, obturator, external iliac, or presacral lymph node metastasis). N3: Metastasis to the common iliac lymph nodes. M0: No distant metastasis. M1: Distant metastasis. (AJCC 7th ed.)

关联

项与膀胱尿路上皮癌Ⅳ期相关的药物

Pembrolizumab

帕博利珠单抗

靶点

PD-1

作用机制

PD-1抑制剂

在研机构

原研机构

在研适应症

非在研适应症

最高研发阶段批准上市

首次获批国家/地区

美国

首次获批日期2014-09-04

Nivolumab

纳武利尤单抗

靶点

PD-1

作用机制

PD-1抑制剂

在研机构

National Cancer Institute [+29]

原研机构

Ono Pharmaceutical Co., Ltd. [+1]

在研适应症

胃食管交界处恶性肿瘤 [+503]

非在研适应症

异戊酸血症 [+108]

最高研发阶段批准上市

首次获批国家/地区

日本

首次获批日期2014-07-04

Cabozantinib (s)-Malate

苹果酸卡博替尼

靶点

AXL x RET x ROS1 x TYRO3 x Tie-2 x TrkB x VEGFR1 x VEGFR2 x VEGFR3 x c-Kit x c-Met

作用机制

AXL抑制剂 [+10]

在研机构

原研机构

在研适应症

非在研适应症

最高研发阶段批准上市

首次获批国家/地区

美国

首次获批日期2012-11-29

项与膀胱尿路上皮癌Ⅳ期相关的临床试验

NCT05334069

/ RecruitingN/AIIT

Blinded Reference Set for Multicancer Early Detection Blood Tests

This study collects blood and tissue samples from patients with cancer and without cancer to evaluate tests for early cancer detection. Collecting and storing samples of blood and tissue from patients with and without cancer to study in the laboratory may help researchers develop tests for the early detection of cancers.

开始日期2022-08-18

申办/合作机构

Alliance Foundation Trials LLC

[+1]

NCT04052113

/ CompletedN/A

Real World Evidence of PD-L1, TMB Prevalence and Efficacy of 1st Line Chemotherapy in These High or Low Population for Stage IV Urothelial Cancer

This study is a multi-center, non-interventional study. Patients' background, treatment pattern, treatment outcome, efficacy will be collected from medical records in Stage IV urotherial (UC) patients. Archived patient's formalin-fixed paraffin-embedded (FFPE) primary tumor samples will be collected to assay PD-L1 expression and next generation sequencer (NGS) assay for tumor mutation burden (TMB).

开始日期2019-10-25

申办/合作机构

AstraZeneca PLC

JPRN-UMIN000037727

/ CompletedN/A

Real world evidence of PD-L1, TMB prevalence and efficacy of 1st line chemotherapy in these high or low population for stage IV urothelial cancer - YODO study Real world evidence of PD-L1 prevalence and efficacy of 1st line chemotherapy for stage IV urothelial cancer

开始日期2019-09-01

申办/合作机构

AstraZeneca KK

[+1]

100 项与膀胱尿路上皮癌Ⅳ期相关的临床结果

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100 项与膀胱尿路上皮癌Ⅳ期相关的转化医学

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0 项与膀胱尿路上皮癌Ⅳ期相关的专利（医药）

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项与膀胱尿路上皮癌Ⅳ期相关的文献（医药）

2024-10-01·Clinical Genitourinary Cancer

Rates of Systemic Therapy for Metastatic Bladder Cancer Are Lower in Unmarried Males and Females

Article

作者: Karakiewicz, Pierre I. ; Vitucci, Kira ; Bello, Francesco Di ; Baudo, Andrea ; Goyal, Jordan A. ; Kluth, Luis A. ; Chun, Felix K.H ; de Angelis, Mario ; de Cobelli, Ottavio ; Jannello, Letizia M.I ; Carmignani, Luca ; Tian, Zhe ; Shariat, Shahrokh F. ; Saad, Fred ; Briganti, Alberto ; Siech, Carolin ; Longo, Nicola

OBJECTIVESystemic therapy is guideline-recommended for metastatic urothelial carcinoma of the urinary bladder (UCUB). Unmarried status represents an important barrier to treatment access in many primaries. The importance of married status is unknown in the context of systemic therapy in metastatic UCUB and was addressed in the current study.METHODSWe relied on the Surveillance, Epidemiology, and End Results database (2004-2020) to identify patients with metastatic UCUB. Univariable and multivariable logistic regression models were fitted to address systemic therapy rates. Additionally, temporal trends were plotted.RESULTSOverall, 6873 patients with stage IV UCUB were identified. Of those, 4853 (71%) were male. Of males, 2993 (62%) were married vs. 797 (39%) of females. The rates of systemic therapy were 55% in both married males and married females. Married males and females differed from their unmarried counterparts regarding age and race/ethnicity. In males, prior to any adjustment, married status was associated with an odds ratio of 1.46 (P < .001). After adjustment for age and race/ethnicity, the odds ratio increased to 1.73 (P < .001). In females, prior to any adjustment, married status was associated with an odds ratio of 1.94 (P < .001). After adjustment for age and race/ethnicity, the odds ratio decreased to 1.57 (P < .001).CONCLUSIONUnmarried males and unmarried females are significantly exposed to lower access to systemic therapy compared to their married counterparts. In consequence, both unmarried men and unmarried women should be given very careful consideration when use of systemic therapy in metastatic UCUB is contemplated.

2024-08-01·The American Journal of Dermatopathology

Enfortumab Vedotin Drug Eruption: Cutaneous Adverse Events and Histopathologic Findings

Article

作者: Wanat, Karolyn ; Saab-Chalhoub, Mario ; Roth, Gretchen ; Casale, Fiore

Abstract:Enfortumab is a monoclonal antibody directed against nectin-4 and, when combined with vedotin, is an antibody–drug conjugate approved for the treatment of locally advanced or metastatic urothelial cancers. A 75-year-old woman with stage IV papillary urothelial carcinoma of the bladder who completed cycle 2 of enfortumab vedotin (EV) infusions presented to our dermatology department for new-onset symmetric and painful dusky erythematous patches on the extremities and trunk without mucosal involvement. Two biopsies were obtained, which revealed an interface dermatitis with notable ring mitoses within the basal and suprabasal layers of the epidermis without epidermal necrosis. The patient was diagnosed with toxic erythema of chemotherapy and improved with application of triamcinolone 0.1% ointment twice daily without discontinuation of her EV infusions. Although a targeted therapy, EV commonly exhibits cutaneous side effects due to the expression of nectin-4 in the skin. Most cutaneous side effects are mild and can be managed symptomatically. However, severe drug-induced eruptions, such as toxic epidermal necrolysis, have been described. The histologic findings of EV associated skin eruptions can aid in correctly identifying the culprit drug and assist in management. This case provides insights for dermatologists by highlighting the common cutaneous side effects of EV and the associated histologic findings as this targeted therapy becomes increasingly utilized in the treatment of refractory neoplasms.

2024-06-27·Cureus

Multi-organ Thromboembolic Crisis: A Case Report of Concomitant Stroke, Myocardial Infarction, and Pulmonary Embolism

Article

作者: Al Hage, Abe ; Fourtounis, Joanna V ; Butler, Seth P ; Swan, Kirby W ; Gunaga, Satheesh

Management of acute coronary syndrome (ACS), cerebrovascular accident (CVA), and pulmonary embolism (PE) necessitates prompt intervention, as delayed treatment may lead to severe consequences. Each of these conditions presents significant challenges and carries a high risk of morbidity and mortality. We present the case of an 86-year-old female with a history of stage 4 urothelial carcinoma metastasized to the lungs, who presented to the emergency department (ED) with acute ischemic stroke (AIS), ST-segment elevation myocardial infarction (STEMI), and bilateral PE. We propose the term "multi-organ thromboembolic crisis" (MOTEC) to streamline the communication and management approach for patients experiencing critical thromboembolic events affecting multiple organ systems.

项与膀胱尿路上皮癌Ⅳ期相关的新闻（医药）

2022-02-17

·PATSNAP

中位OS达14.6个月！君实生物公布PD-1抑制剂尿路上皮癌最新数据

2022年美国临床肿瘤学会泌尿生殖系统肿瘤研讨会（ASCO-GU）将于当地时间2月17日~19日举办。君实生物宣布，在本届大会上，该公司的PD-1抑制剂特瑞普利单抗将公布多项在泌尿肿瘤领域的研究数据。其中POLARIS-03研究更新的随访2年生存数据显示：特瑞普利单抗治疗化疗难治性的转移性尿路上皮癌患者中位总生存期（OS）为14.6个月，且未发现新的安全信号。特瑞普利单抗是君实生物研发的抗PD-1抗体，已在中国获批治疗多个适应症，涉及黑色素瘤、鼻咽癌、尿路上皮癌多个癌种。本届ASCO-GU大会上，POLARIS-03研究再次以壁报形式更新了特瑞普利单抗治疗既往全身治疗失败的晚期尿路上皮癌患者2年生存数据以及生物标志物分析结果，该研究由北京大学肿瘤医院郭军教授和上海交通大学医学院附属仁济医院黄翼然教授共同牵头。 POLARIS-03研究为一项开放标签、多中心、2期注册临床研究，2017年5月至2019年9月间，在全国15家研究中心共纳入151例晚期尿路上皮癌患者，所有患者均接受了特瑞普利单抗治疗，直至出现疾病进展、无法耐受的毒性或自愿退出。2021年11月，POLARIS-03研究已在《临床癌症研究》杂志上在线发表了末例患者入组后12个月时的研究数据。本次在ASCO-GU大会上发布的随访2年生存数据显示：截至2021年9月8日（末例患者入组后24个月），中位总生存期（OS）为14.6个月。同时，随访期间未发现新的安全信号。研究对尿路上皮癌患者的肿瘤突变负荷（TMB）进行了检测和分析发现，高水平TMB患者组可以获得更高的治疗缓解率、更长的无进展生存期（PFS）和OS。而在135例患者的WES检测结果中发现，SMARCA4/PBRM1或肿瘤抑制因子RB1突变，或FRFR2/FGFR3基因突变或基因融合，或NECTIN4基因组改变的患者更有可能在特瑞普利单抗治疗后获得应答。研究认为，POLARIS-03研究2年的随访数据显示：特瑞普利单抗治疗化疗难治性的转移性尿路上皮癌患者具有令人鼓舞的临床疗效，且患者中位OS超过1年，为14.6个月；而在TMB分析中发现，晚期尿路上皮癌患者存在高水平TMB时可能更容易在特瑞普利单抗的治疗下获益；研究的WES分析结果可能为此类患者未来的免疫精准治疗提供更多研究思路。除了POLARIS-03研究，特瑞普利单抗还有多项研究结果也将在本届大会上公布，包括：一项新辅助特瑞普利单抗治疗试验RJBLC-I2N003，研究在肌肉浸润性膀胱癌（MIBC）患者中使用特瑞普利单抗进行新辅助治疗，以评估该方案的有效性和安全性；另一项为RC48-C014研究的更新数据，该研究旨在评估特瑞普利单抗联合RC48-ADC（一种新型人源化 HER2抗体偶联药物）治疗HER2阳性甚至阴性转移性尿路上皮癌患者的效果。参考资料： [1] ASCO-GU22 | POLARIS-03研究更新随访2年生存数据，基因分析结果助力免疫精准治疗. Retrieved Feb 16 2022, from https://mp.weixin.qq.com/s/KZlNnjFg8trE7KcilxNO_A 内容来源于网络，如有侵权，请联系删除，谢谢。

免疫疗法抗体ASCO会议AACR会议抗体药物偶联物