Work

Adjuvant treatment preferences in high-risk upper tract urothelial carcinoma: the perspective of Portuguese medical oncologists

Year: 2025

Type: article

Abstract: Although upper tract urothelial carcinoma (UTUC) and bladder urothelial carcinoma (BUC) share histological features, they differ in clinical behavior and management. Valid adjuvant options include surveillance, platinum-based chemotherapy, and immune checkpoint inhibitors (ICIs). To assess real-world practice, we conducted a survey among Portuguese medical oncologists dedicated to genitourinary malignancies, exploring their preferences for adjuvant therapy in high-risk UTUC (illustrated as pT2N1M0) across three clinical scenarios that differed by PD-L1 status and renal function. Among 34 respondents, cisplatin plus gemcitabine was the preferred regimen in cisplatin-eligible patients, regardless of PD-L1 status (94% in PD-L1-negative and 85% in PD-L1-positive tumors). In PD-L1-positive, cisplatin-ineligible patients, carboplatin plus gemcitabine was preferred (47%), followed by ICIs (44%). These findings suggest a consistent preference for platinum-based chemotherapy, likely reflecting UTUC-specific evidence from the POUT trial and apparent limited ICI benefit in this subgroup, underscoring the need for dedicated prospective trials.

Source: The Oncologist

DOI: 10.1093/oncolo/oyaf365

Authors: Guilherme Vilhais, Mário Fontes-Sousa

Language: English

Topic: Bladder and Urothelial Cancer Treatments

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,852

OpenAlex ID: W4415703182