Smith Katherine Emilie Rhoades, Hitron Emilie Elise, Russler Greta A, Baumgarten Deborah A, Bilen Mehmet Asim
Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA.
Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, GA, USA.
J Immunother Precis Oncol. 2020 Jan 7;3(1):23-26. doi: 10.4103/JIPO.JIPO_22_19. eCollection 2020 Feb.
Metastatic urothelial carcinoma (mUC) has a poor prognosis with a 5-year survival probability of 4.8%. The mainstay of first-line treatment is platinum-based chemotherapy. Second-line therapy involves immune checkpoint inhibitors or a fibroblast growth factor receptor (FGFR) inhibitor, erdafitinib, for patients harboring selected alterations. Several additional agents are under development for the treatment of mUC. Recent studies demonstrate that ramucirumab and docetaxel have clinical activity in mUC. We report two patients with metastatic upper tract urothelial cancer (mUTUC) with alterations who were heavily pretreated with FGFR inhibitors that later showed response to ramucirumab and docetaxel. Preclinical studies indicate that FGF and VEGF pathways work synergistically, which could explain the observations in our patients. Our findings may represent another treatment option for patients with mUC and alterations who have progressed on multiple lines of therapy.
转移性尿路上皮癌（mUC）预后较差，5年生存概率为4.8%。一线治疗的主要方法是铂类化疗。二线治疗包括免疫检查点抑制剂或针对存在特定改变的患者使用成纤维细胞生长因子受体（FGFR）抑制剂厄达替尼。还有几种其他药物正在研发用于治疗mUC。近期研究表明，雷莫西尤单抗和多西他赛在mUC中具有临床活性。我们报告了2例患有转移性上尿路尿路上皮癌（mUTUC）且存在特定改变的患者，他们之前接受了大量FGFR抑制剂治疗，后来对雷莫西尤单抗和多西他赛产生了反应。临床前研究表明，FGF和VEGF通路协同发挥作用，这可以解释我们患者中的观察结果。我们的发现可能为在多线治疗中病情进展的mUC及特定改变患者提供了另一种治疗选择。
