Уротеліальна карцинома
Детермінований перегляд YAML-сутності з джерельної бази. Клінічний авторитет лишається за вказаними source ID та статусом клінічного sign-off.
| ID | DIS-UROTHELIAL |
|---|---|
| Тип | Хвороба |
| Синоніми | Bladder cancerTCCUrothelial carcinomaУротеліальна карцинома |
| Статус | очікує клінічного підпису |
| Хвороби | Не вказано |
| Джерела | SRC-EAU-BLADDER-2024 SRC-NCCN-BLADDER-2025 |
Інформаційна підтримка. Усі рекомендації має перевірити кваліфікований онколог. Технічні перевірки не є клінічною валідацією чи схваленням лікування.
| icd_o_3_morphology | 8120/3 |
|---|---|
| icd_o_3_topography | ["C67.9", "C65.9", "C66.9"] |
| icd_10 | C67 |
| who_classification | Urothelial carcinoma (WHO 5th 2022) |
Нотатки
Архетип line_of_therapy_sequential — стан захворювання є домінантною точкою розгалуження. Придатність до цисплатину (cisplatin) була принциповим питанням до ери enfortumab vedotin.
Де використовується
Algorithms
ALGO-AMSTERDAM-II-LYNCH- ALGO-AMSTERDAM-II-LYNCHALGO-PREMM5-LYNCH- ALGO-PREMM5-LYNCHALGO-UROTHELIAL-METASTATIC-1L- ALGO-UROTHELIAL-METASTATIC-1LALGO-UROTHELIAL-METASTATIC-2L- ALGO-UROTHELIAL-METASTATIC-2L
Questionnaires
QUEST-UROTHELIAL-1L-STUB- Urothelial carcinoma — first line
Sources
SRC-BLC2001-LORIOT-2019- Erdafitinib in Locally Advanced or Metastatic Urothelial CarcinomaSRC-EAU-BLADDER-2024- EAU Muscle-Invasive BladderSRC-EV301-POWLES-2021- Enfortumab vedotin in previously treated advanced urothelial carcinomaSRC-EV302-POWLES-2024- Enfortumab Vedotin and Pembrolizumab in Untreated Advanced Urothelial CancerSRC-JAVELIN-BLADDER100-POWLES-2020- Avelumab First-Line Maintenance for Advanced Urothelial CarcinomaSRC-KEYNOTE-045-BELLMUNT-2017- Pembrolizumab as second-line therapy for advanced urothelial carcinomaSRC-NCCN-BLADDER-2025- NCCN Bladder CancerSRC-THOR-LORIOT-2023- Erdafitinib or Chemotherapy in Advanced or Metastatic Urothelial Carcinoma
Клінічна застосовність
BMA-FGFR2-MUTATION-UROTHELIAL- FGFR2 fusion / activating mutation in metastatic urothelial carcinoma: erdafitinib (BLC20...BMA-FGFR3-R248C-UROTHELIAL- FGFR3 R248C is an extracellular-domain activating mutation included in the erdafitinib co...BMA-FGFR3-S249C-UROTHELIAL- FGFR3 S249C is the most common activating FGFR3 mutation in urothelial carcinoma. Erdafit...BMA-FGFR3-TACC3-UROTHELIAL- FGFR3-TACC3 fusion is an activating rearrangement in urothelial carcinoma (~2-3%). Includ...BMA-FGFR3-Y373C-UROTHELIAL- FGFR3 Y373C is a transmembrane-domain activating mutation in urothelial carcinoma; includ...BMA-MLH1-GERMLINE-UROTHELIAL- MLH1 germline loss-of-function in urothelial produces dMMR/MSI-H phenotype. Pan-tumor MSI...BMA-MLH1-SOMATIC-UROTHELIAL- MLH1 somatic loss-of-function in urothelial produces dMMR/MSI-H phenotype. Pan-tumor MSI-...BMA-MSH2-GERMLINE-UROTHELIAL- MSH2 germline loss-of-function in urothelial produces dMMR/MSI-H phenotype. Pan-tumor MSI...BMA-MSH2-SOMATIC-UROTHELIAL- MSH2 somatic loss-of-function in urothelial produces dMMR/MSI-H phenotype. Pan-tumor MSI-...BMA-MSH6-GERMLINE-UROTHELIAL- MSH6 germline loss-of-function in urothelial produces dMMR/MSI-H phenotype. Pan-tumor MSI...BMA-MSH6-SOMATIC-UROTHELIAL- MSH6 somatic loss-of-function in urothelial produces dMMR/MSI-H phenotype. Pan-tumor MSI-...BMA-PIK3CA-HOTSPOT-UROTHELIAL- PIK3CA mutations in ~20% of muscle-invasive bladder. No PI3Ki approval; FGFR3-driven (erd...BMA-PMS2-GERMLINE-UROTHELIAL- PMS2 germline loss-of-function in urothelial produces dMMR/MSI-H phenotype. Pan-tumor MSI...BMA-PMS2-SOMATIC-UROTHELIAL- PMS2 somatic loss-of-function in urothelial produces dMMR/MSI-H phenotype. Pan-tumor MSI-...BMA-RB1-UROTHELIAL- RB1 alterations (deletion, mutation) occur in ~30% of muscle-invasive bladder cancer (MIB...BMA-TP53-MUT-UROTHELIAL- TP53 mutation in UROTHELIAL — common, adverse prognostic; not directly targeted. Per usua...
Показання
IND-ENVIRONMENTAL-ARSENIC-WATER-PREVENTION-EXPOSURE-ELIMINATION- IND-ENVIRONMENTAL-ARSENIC-WATER-PREVENTION-EXPOSURE-ELIMINATIONIND-ENVIRONMENTAL-ARSENIC-WATER-PREVENTION-OBSERVATION- IND-ENVIRONMENTAL-ARSENIC-WATER-PREVENTION-OBSERVATIONIND-IATROGENIC-CYCLOPHOSPHAMIDE-LATE-PREVENTION-OBSERVATION- IND-IATROGENIC-CYCLOPHOSPHAMIDE-LATE-PREVENTION-OBSERVATIONIND-IATROGENIC-CYCLOPHOSPHAMIDE-LATE-PREVENTION-SURVEILLANCE- IND-IATROGENIC-CYCLOPHOSPHAMIDE-LATE-PREVENTION-SURVEILLANCEIND-IATROGENIC-PEDIATRIC-PELVIC-RT-PREVENTION-OBSERVATION- IND-IATROGENIC-PEDIATRIC-PELVIC-RT-PREVENTION-OBSERVATIONIND-IATROGENIC-PEDIATRIC-PELVIC-RT-PREVENTION-SURVEILLANCE- IND-IATROGENIC-PEDIATRIC-PELVIC-RT-PREVENTION-SURVEILLANCEIND-OCC-AROMATIC-AMINES-PREVENTION-OBSERVATION- IND-OCC-AROMATIC-AMINES-PREVENTION-OBSERVATIONIND-OCC-AROMATIC-AMINES-PREVENTION-SURVEILLANCE- IND-OCC-AROMATIC-AMINES-PREVENTION-SURVEILLANCEIND-PENILE-SCC-METASTATIC-1L-MSI-H-PEMBRO- IND-PENILE-SCC-METASTATIC-1L-MSI-H-PEMBROIND-SCHISTOSOMA-HAEMATOBIUM-PREVENTION-OBSERVATION- IND-SCHISTOSOMA-HAEMATOBIUM-PREVENTION-OBSERVATIONIND-SCHISTOSOMA-HAEMATOBIUM-PREVENTION-TREATMENT- IND-SCHISTOSOMA-HAEMATOBIUM-PREVENTION-TREATMENTIND-UROTHELIAL-2L-ERDAFITINIB- IND-UROTHELIAL-2L-ERDAFITINIBIND-UROTHELIAL-2L-EV- IND-UROTHELIAL-2L-EVIND-UROTHELIAL-2L-PEMBROLIZUMAB- IND-UROTHELIAL-2L-PEMBROLIZUMABIND-UROTHELIAL-2L-PLATINUM-CHEMO- IND-UROTHELIAL-2L-PLATINUM-CHEMOIND-UROTHELIAL-METASTATIC-1L-EV-PEMBRO- IND-UROTHELIAL-METASTATIC-1L-EV-PEMBROIND-UROTHELIAL-METASTATIC-1L-PLATINUM-CHEMO-AVELUMAB- IND-UROTHELIAL-METASTATIC-1L-PLATINUM-CHEMO-AVELUMAB
Схема лікування
REG-EV-MONO-UROTHELIAL- Enfortumab vedotin monotherapy (urothelial carcinoma)REG-GEM-CARBO-UROTHELIAL- Gemcitabine + carboplatin (urothelial carcinoma, cisplatin-ineligible)
Тривожна ознака
RF-ACTIVE-AUTOIMMUNE-DISEASE-ICI-RISK- Patient with active or incompletely controlled pre-existing autoimmune or inflammatory di...RF-CASCADE-LYNCH-FDR-POSITIVE- A first-degree relative of the patient (parent, sibling, or child) has a documented posit...RF-ENVIRONMENTAL-ARSENIC-WATER-PREVENTION- Chronic ingestion of arsenic-contaminated drinking water with inorganic arsenic >10 µg/L...RF-IATROGENIC-CYCLOPHOSPHAMIDE-LATE-PREVENTION- Cancer survivor with prior cumulative cyclophosphamide exposure ≥7 g/m² (or ≥30 g lifetim...RF-IATROGENIC-PEDIATRIC-PELVIC-RT-PREVENTION- Cancer survivor ≥5 years post-completion of curative-intent oncology treatment that inclu...RF-LIFESTYLE-TOBACCO-CANCER-PREVENTION- Active tobacco smoking (current smoker OR cessation <15 years) OR smokeless tobacco use O...RF-LYNCH-CONFIRMED-CARRIER- Confirmed germline pathogenic / likely-pathogenic variant in a Lynch syndrome (MMR / EPCA...RF-LYNCH-FAMILY-HISTORY-SUSPICION- Family pedigree meeting criteria suggestive of hereditary nonpolyposis colorectal cancer...RF-OCC-AROMATIC-AMINES-MALIGNANCY-PREVENTION- Documented occupational aromatic-amine exposure — benzidine, 2-naphthylamine, 4-aminobiph...RF-OCC-DIESEL-EXHAUST-PREVENTION- Documented historical occupational exposure to diesel-engine exhaust (DEE) — typical high...RF-OCC-FIREFIGHTER-PREVENTION- Documented historical occupational exposure as a career firefighter (≥10 years in active...RF-OCC-PAH-PREVENTION- Documented historical occupational exposure to polycyclic aromatic hydrocarbons (PAHs) —...RF-OCC-PAINTERS-PREVENTION- Documented historical occupational exposure as a painter — typical high-risk roles includ...RF-SCHISTOSOMA-HAEMATOBIUM-BLADDER-PREVENTION- History of Schistosoma haematobium infection (positive ova in urine, positive serology, o...RF-UROTHELIAL-EV-CONTRAINDICATED- Enfortumab vedotin (EV) contraindication in urothelial carcinoma — MMAE-related toxicity...RF-UROTHELIAL-FRAILTY-AGE- Urothelial cancer patient cisplatin-ineligible by Galsky criteria: ECOG ≥2, OR CrCl <60 m...RF-UROTHELIAL-HIGH-RISK-BIOLOGY- FGFR3 mutation/fusion — opens erdafitinib (THOR) pathway.RF-UROTHELIAL-INFECTION-SCREENING- Active or latent infection requiring resolution / prophylaxis before initiating ICI (pemb...RF-UROTHELIAL-ORGAN-DYSFUNCTION- Cisplatin-ineligibility per Galsky criteria — drives EV+pembro 1L OR carbo-doublet.RF-UROTHELIAL-TRANSFORMATION-PROGRESSION- Hydronephrosis OR ureteral obstruction — emergent urological intervention before systemic...