{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:40:20Z","timestamp":1760143220384,"version":"build-2065373602"},"reference-count":45,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2024,1,25]],"date-time":"2024-01-25T00:00:00Z","timestamp":1706140800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"EMD Serono Canada","award":["202308.4398.QC"],"award-info":[{"award-number":["202308.4398.QC"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Current Oncology"],"abstract":"<jats:p>Locally advanced or metastatic urothelial carcinoma (aUC) presents a significant challenge with high mortality rates. Platinum-based chemotherapy remains the established frontline standard of care, and a switch-maintenance strategy with immunotherapy has now emerged as a new standard for aUC patients without disease progression, following initial platinum therapy. Examining the treatment patterns is imperative, given the evolving therapeutic landscape. In this study, we conducted a retrospective medical chart review of 17 Canadian oncologists treating patients with aUC to assess unmet needs in Canadian aUC patient care. Data from 146 patient charts were analyzed, revealing important clinical insights about the management of aUC. A substantial proportion of patients (53%) presented with de novo metastatic disease, which was possibly influenced by pandemic-related care disruptions. Variability was evident in the cisplatin eligibility criteria, with a majority (70%) of oncologists utilizing a 50 mL\/min threshold. Most favored four cycles of platinum-based chemotherapy to spare the bone marrow for future therapies and prevent patient fatigue. Notably, some eligible patients were kept under surveillance rather than receiving maintenance therapy, suggesting a potential gap in awareness regarding evidence-based recommendations. Furthermore, managing treatment-related adverse events was found to be one of the biggest challenges in relation to maintenance immunotherapy. In conclusion, our findings provide the first comprehensive overview of aUC treatment patterns in Canada following the approval of maintenance immunotherapy, offering insights into the decision-making process and underscoring the importance of evidence-based guidelines in aUC patient management.<\/jats:p>","DOI":"10.3390\/curroncol31020052","type":"journal-article","created":{"date-parts":[[2024,1,25]],"date-time":"2024-01-25T10:32:38Z","timestamp":1706178758000},"page":"704-722","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Real-World Retrospective Analysis of the Management of Advanced Urothelial Carcinoma in Canada"],"prefix":"10.3390","volume":"31","author":[{"given":"Feras A.","family":"Moria","sequence":"first","affiliation":[{"name":"McGill University Health Center, Montreal, QC H4A 3J1, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Changsu L.","family":"Park","sequence":"additional","affiliation":[{"name":"McGill University Health Center, Montreal, QC H4A 3J1, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernhard J.","family":"Eigl","sequence":"additional","affiliation":[{"name":"BC Cancer Vancouver Centre, Vancouver, BC V5Z 4E6, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robyn","family":"Macfarlane","sequence":"additional","affiliation":[{"name":"QEII Health Sciences Centre, Halifax, NS B3H 2Y9, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7057-7492","authenticated-orcid":false,"given":"Michel","family":"Pavic","sequence":"additional","affiliation":[{"name":"Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ramy R.","family":"Saleh","sequence":"additional","affiliation":[{"name":"McGill University Health Center, Montreal, QC H4A 3J1, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,1,25]]},"reference":[{"key":"ref_1","unstructured":"(2023, July 27). 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