Treatment strategies for locally advanced and metastatic urothelial carcinoma based on molecular profiles: A Review.

Urothelial carcinoma (UC), which includes bladder carcinoma (accounting for 90-95% of cases) and upper urinary tract carcinoma (comprising 5-10%), is one of the most prevalent malignancies worldwide. For several decades, platinum-based chemotherapy has been the primary treatment modality for this disease. However, recent advancements have significantly transformed the therapeutic landscape for patients with UC. This transformation has been facilitated by the introduction of various treatment options, including immune checkpoint inhibitors targeting PD-L1 or PD-1, antibody-drug conjugates that target nectin-4 or trophoblast cell surface antigen 2 expressed on cancer cells, and fibroblast growth factor receptor (FGFR) inhibitors specifically indicated for Patients with UC with FGFR3 mutations. Although these novel therapies have demonstrated marked survival benefits for patients with locally advanced or metastatic UC, their efficacy can vary depending on the specific molecular profile present on cancer cells. In this review, we summarize the molecular classifications of UC and the corresponding treatment landscape associated with these classifications.