Treatment of metastatic bladder cancer: current and historical aspects

The “state-of-art” treatment approach for patients with metastatic urothelial cancer (eg, bladder or other tumors of urinary tract) is platinum-containing chemotherapy, however, despite the high immediate efficacy therapy (up to 70% objective response rate), long-term results remain unsatisfactory, median progression-free and overall survival usually do not exceed 6 12 months respectively, visceral metastases poor performance status have a particularly dismal prognosis. most effective this disease cisplatin-containing ddMVAC (methotrexate, vinblastine, doxorubicin, cisplatin) GC (gemcitabine, regimens are effective, in real world setting minority can tolerate these options. Recent advances associated discoveries field immunotherapy by targeting PD-1/PD-L1 pathway. promising first line based on sequential use chemotherapy maintenance avelumab therapy, latter drug has been proven increase cancer. This article discusses key data effectiveness systemic cancer, as well potential ways improve disease, primarily through introduction into clinical practice expanding category who eligible chemotherapy.