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Published in Bladder Cancer

Expert Opinion / Cases · November 12, 2020

High-grade Urothelial Cancer

Written by
Daniel E. Lage MD, MSc


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  • Guru Sonpavde

    Nov 15, 2020

    Answers to questions:
    1. In absence of trial, I would institute docetaxel (without enthusiasm).
    2. In presence of FGFR2/3 activating genomic alteration, I would have administered erdafitinib as second-line therapy when patient recurred after radical cystectomy (before pembrolizumab).
    3. With current data, no adjuvant therapy is proven, but CHECKMATE274 data are eagerly awaited (Nivolumab improved DFS in all-comers and PD-L1+ patients according to press release).
    4. Current optimal systemic therapy for CNS metastases is unclear. Currently, I advise controlling CNS lesions with palliative radiation and institute systemic therapy immediately thereafter.
    5. Estimated survival is dismal with CNS metastases (probably worse than liver metastasis, a known poor prognostic factor).

  • Jul 07, 2022

    Pending Moderator approval.

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