Dr. O'Donnell on the Importance of Identifying Molecular Subsets in Urothelial Cancer

Peter O’Donnell, MD, associate professor of medicine, University of Chicago Medicine, discusses the importance of identifying molecular subsets in urothelial cancer.

A lot of progress has been made in urothelial cancer, says O’Donnell, but the future is likely to rely more heavily on molecular subsets. At O’Donnell’s practice, every patient with metastatic disease is offered genomic sequencing in the frontline metastatic setting. Specifically, this occurs during the time they receive platinum-based chemotherapy as the identification of certain genomic targets may qualify patients for clinical trials.

For example, patients with HER2 or ERBB family alterations may be eligible for clinical trials, says O’Donnell. Data have been published that have shown promise for those patients. Additionally, PARP inhibitors can be used to target DNA repair mutations. Genomic sequencing may have a direct role in positioning a patient to receive a certain therapy if it becomes approved down the line, adds O’Donnell. Previously, patients with FGFR alterations were eligible for trials and now have access to FGFR3 inhibitor therapy.