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This retrospective cohort study evaluated characteristics, treatment patterns, and clinical outcomes in adults with locally advanced/metastatic urothelial carcinoma (la/mUC) receiving first-line (1L) systemic treatment with or without avelumab 1L maintenance (1LM) between January 2020 and July 2023. The index date was the first date with a claim for 1L systemic therapy after a la/mUC diagnosis. Patients with continuous health plan enrollment for ≥6 months before and ≥1 month after the index date were identified from Carelon Research's Healthcare Integrated Research Database. Of 2820 patients receiving 1L treatment, 37.0% received platinum-based chemotherapy (PBC); 39.0%, immuno-oncology (IO) monotherapy; and 24.0%, other therapies. Renal disease and other comorbidities influenced 1L regimen choice. Healthcare resource utilization (HCRU) and costs were reported for patients receiving second-line (2L) treatment. HCRU was high in 32.8% of patients (926 of 2820) who received 2L treatment. Median all-cause direct medical costs per patient per month were USD 15,859, USD 19,781, USD 11,346, and USD 9516 for 1L PBC, 1L PBC + avelumab 1LM, 1L IO monotherapy, and 1L other therapies, respectively. Most direct healthcare costs were attributed to all-cause outpatient visits.
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http://dx.doi.org/10.3390/curroncol32070384 | DOI Listing |
Nat Rev Urol
September 2025
Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
Low-grade non-muscle invasive bladder cancer is a specific category of bladder cancer with a favourable prognosis; however, its management presents several challenges. The risk of stage progression is very low, but approximately half of patients will experience recurrence within the first 5 years after diagnosis. This high propensity for recurrence, coupled with the threat of progression, mandates ongoing surveillance.
View Article and Find Full Text PDFNat Commun
September 2025
Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA, USA.
With the approval of the antibody-drug conjugate enfortumab vedotin (EV), NECTIN4 has emerged as a bona fide therapeutic target in urothelial carcinoma (UC). Here, we report the development of a NECTIN4-directed chimeric antigen receptor (CAR) T cell, which exhibits reactivity across cells expressing a range of endogenous NECTIN4, with enhanced activity in high expressors. We demonstrate that the PPARγ pathway, critical for luminal differentiation, transcriptionally controls NECTIN4, and that the PPARγ agonist rosiglitazone primes and augments NECTIN4 expression, thereby increasing sensitivity to NECTIN4-CAR T cell-mediated killing.
View Article and Find Full Text PDFCureus
August 2025
Department of Urology, Graduate School of Medicine, Yamaguchi University, Ube, JPN.
Introduction Currently, treatment regimens incorporating immune checkpoint inhibitors (ICIs) are the standard of care for locally advanced or metastatic urothelial carcinoma (la/mUC). This study aimed to investigate the association between the neutrophil-to-eosinophil ratio (NER) and the occurrence of immune-related adverse events (irAEs) as well as treatment outcomes. Methods This multicenter retrospective study examined patients with la/mUC treated with ICIs between January 2017 and December 2022.
View Article and Find Full Text PDFCureus
August 2025
Department of Urology, The Institute of Medical Science, The University of Tokyo, Tokyo, JPN.
In patients with advanced urothelial carcinoma who have progressed after platinum-based chemotherapy, enfortumab vedotin (EV) improves overall survival compared to standard chemotherapy. Additionally, for treatment-naïve patients with locally advanced or metastatic urothelial carcinoma, the combination of pembrolizumab and EV demonstrates superior efficacy over platinum-based chemotherapy. Hence, EV becomes a standard treatment option.
View Article and Find Full Text PDFInt J Surg Case Rep
September 2025
Department of Urology, The Second Affiliated Hospital, Kunming Medical University, Yunnan Province, China. Electronic address:
Introduction: Diffuse large B-cell lymphoma (DLBCL), a common subtype of non-Hodgkin lymphoma (NHL), originates primarily from lymph nodes, with a small proportion arising extranodally in sites such as the gastrointestinal tract and central nervous system. Given the general absence of lymphoid tissue in the bladder, primary bladder DLBCL is exceptionally rare.
Case Presentation: This case report describes an 83-year-old male patient with a bladder mass, initially suspected as cystitis glandularis, ultimately diagnosed via pathological examination as DLBCL.