Overview of Urothelial Carcinoma: A Global Burden


Disease characteristics and risk factors associated with urothelial carcinoma that create a significant burden for patients, loved ones, and health care professionals across the globe.

Petros Grivas, MD, PhD: Hello, and thank you for joining this Targeted Oncology™ presentation titled, “Targeting Trop-2 in Advanced Urothelial Carcinoma.” The treatment landscape of advanced urothelial cancer has transformed over the past 5 years with the addition of immune checkpoint inhibitors, targeted therapies like FGFR inhibitors, and antibody-drug conjugates. The first Trop-2–directed antibody-drug conjugate for advanced urothelial cancer was approved by the FDA as of April 2021. In today’s Precision Medicine in Oncology® discussion, we will discuss the role of Trop-2 in advanced urothelial cancer and the data supporting its use and FDA approval.

I am Dr Petros Grivas. I am an associate professor in the division of medical oncology, department of medicine, at the University of Washington School of Medicine, and the clinical research division at the Fred Hutchinson Cancer Research Center. I am a practicing oncologist at Seattle Cancer Care Alliance, and I’m also serving as the clinical director of the genitourinary cancers program here. I am very excited, because joining me is Dr Neeraj Agarwal, who is a professor of internal medicine and a senior director of clinical research innovation at Huntsman Cancer Institute at the University of Utah in Salt Lake City. Dr Agarwal has made substantial contributions in the field across the spectrum of genitourinary cancers. It’s very exciting to be able to do this today with him. Neeraj, thank you so much for joining me.

Neeraj Agarwal, MD: This is always a pleasure. Dr Grivas, I’ll call you Petros, as your friend. It’s always an honor to discuss the current or emerging landscape in metastatic bladder cancer with an internationally recognized expert like yourself.

Petros Grivas, MD, PhD: Thank you so much, Neeraj. I will have the pleasure to also call you by your first name. Everybody recognizes how much impact you’ve had in the field. Let’s start this discussion about the prevalence, how common bladder cancer is. It’s the fourth most common cancer in men, and the fifth most common cancer if you also take women into account. It’s the most expensive cancer to treat from diagnosis to death on a per-patient basis, which is shocking when you think about how common a problem it is. Can you comment on that, the global impact of bladder cancer, and potential causes?

Neeraj Agarwal, MD: Absolutely. Looking at data from the American Cancer Society, there will be 83,000 patients with newly diagnosed bladder cancer in the United States in 2021, and 17,000 deaths because of bladder cancer. It’s a very significant issue; it’s not a trivial issue. It’s a very common cancer, as you just mentioned. Obviously, it’s way more common in men than women; its incidence is 4 times higher in men than women. The median age of diagnosis is 73 years. Smoking remains the cause of bladder cancer in 47% of cases in the United States, which is unfortunate because it’s so preventable. That sums up the prevalence and epidemiology of bladder cancer in the United States.

If you go beyond the United States, it’s a common problem across the world. Surprisingly, I learned a long time ago about different kinds of bladder cancers that can exist with different histologies. Squamous cell bladder cancer is quite common in Egypt and may be associated with a worm infection there. In many other parts of the world, it could be associated with the chewing of tobacco, not so much smoking of tobacco. There are countless chemicals associated with bladder cancer. It’s a major public problem, and I’m so glad we’re talking about newer treatment options in bladder cancer today.

Transcript edited for clarity.

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