The first registry to map treatments in over 50 national centers is underway. Approximately 7,300 metastatic patients each year. Blood in the urine, the spy that should never be underestimated
How to best treat patients, often elderly, with metastatic bladder cancer? The strategies available today are different: in addition to surgery and chemotherapy, they can play a role radiotherapy and immunotherapy. And there are, after many years of waiting, other new drugs on the way. But what is the order in which to proceed that offers the most possibilities for preventing any recurrences, both local and remote? Which the best combinations between the various options, which in addition to bringing home the desired result against cancer, also guarantees a better quality of life for the sick? To answer all these questions, the first national register activated by the Federation of Italian cooperative oncology groups (FICOG) has just started, which will collect data in over 50 centers of the peninsula with the aim of mapping how is metastatic urothelial carcinoma treated and understand what they are the most suitable therapies for the individual patient.
Watch out for blood in the urine
Are approximately 29,200 new cases of bladder cancer diagnosed every year in Italy, the fourth most frequent form of cancer in our country after the age of 50: although it mainly affects men, the numbers are growing in women mainly due to the increase in smokers (cigarettes are responsible for 43% of male urothelial neoplastic pathologies and 25% of female ones). In 75% of patients the disease is detected in the early stage and confined to the superficial parts of the bladder wall, when possible to intervene surgically with good healing opportunities. On the other hand, they are more difficult to manage metastatic cases which amount in Italy to about a 7,300 a year. Urothelial carcinoma, more commonly called bladder cancer, is a malignant neoplasm that originates from the urothelium, the mucosa that lines the bladder internally and the upper urinary tract that carries urine from the kidney into the bladder, which is the organ most affected by this tumor,” he explains Joseph Procopius, director of the prostate and genitourinary medical oncology program at the IRCCS Foundation of the National Cancer Institute of Milan —. The main alarm bell is the presence of blood in the urine: an obvious symptom that must be reported as soon as possible to your doctor and to the urologist specialist to perform more specific tests with diagnostic intent. Precious time: achieve early diagnosis means not only that the chances of healing are greater, because the disease is still localized and has not given metastases, but also be treated with less invasive therapieswith fewer side effects and a better quality of life.
Personalize care
When it is possible to detect the neoplasm in the early stages, the median survival of patients five years after diagnosis of 80%. Treatments include surgery if possible, sometimes radiation therapy, and various types of chemotherapy (in the presence of advanced-stage cancer). Thanks to the successes of scientific research, today new effective options are also available for many patients with advanced stage cancer. Metastatic cases are treated with chemotherapy, immunotherapy or radical cystectomy, which for a very complex surgery, even more so if we consider the advanced age of many patients – adds Procopio -. then the arrival, also in our country, of new treatments which have demonstrated clinically relevant benefits. Among these is sacituzumab govitecan, an antibody-drug conjugate already used in metastatic triple-negative breast cancer. In the USA it was approved for patients affected by locally advanced or metastatic urothelial carcinoma, previously treated with chemotherapy. Among the objectives of the Ficog register (the creation of which was made possible with the unconditional support of Gilead Sciences) there is also that of proceeding from the point of view of personalization of carei.e. understanding what are the optimal combinations and sequences of treatments, taking into account the neoplasm and the condition of the individual patient.
The new registry
a research project of which there is an absolute need in our country – he underlines Carmine Pinto, president Figog -. We managed to involve over 50 facilities and achieved uniform coverage of the entire national territory, also to understand how this neoplasm is treated today in large and small Italian centers. We expect to enroll about a thousand patients in two years. The SATURNO study is multicenter, prospective and aims to collect data regarding the management of patients with metastatic urothelial carcinoma undergoing active treatment or supportive care, in line with national and international recommendations. Through careful monitoring and subsequent processing of the data, we want produce new scientific evidence about the efficacy of treatments. At the same time, the register will be able to bring out the more or less unsatisfied needs of the sick. Despite progress, bladder cancer causes more than 6,000 deaths a year in Italy and specialists are also concerned about the increase in incidence. We need to make this tumor and its causes more known – concludes Pinto -. Few people know that smokers are at least three times higher risk to develop cancer compared to non-smokers. This partly explains the increase in the incidence between women, greater than that recorded among men. Another full-blown risk factor exposure to chemicals found in some dyes, herbicides or hydrocarbons. Specific screening programs have been launched in recent years for workers at risk.
April 20, 2023 (change April 20, 2023 | 2:57 pm)
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