Significant progress has been achieved over the last decades in understanding the biology and mechanisms of tumor progression in urothelial carcinoma (UC). Although the therapeutic landscape has dramatically changed in recent years with the introduction of immune checkpoint inhibitors, advanced UC is still associated with rapidly progressing disease and poor survival. The increasing knowledge of the pathogenesis and molecular pathways underlying cancer development and progression is leading the introduction of target therapies, such as the recently approved FGFR inhibitor Erdafitinib, or the anti-nectin 4 antibody drug-conjugate Enfortumab vedotin. Antibody drug conjugates represent an innovative therapeutic approach that allows the combination of a tar get-specific monoclonal antibody covalently conjugated via a linker to a cytotoxic agent (payload). UC is a perfect candidate for this therapeutic approach since it is particularly enriched in antigen expression on its surface and each specific antigen can represent a potential therapeutic target. In this review we summarize the mechanism of action of ADCs, their applications in localized and metastatic UC, the main mechanisms of resistance, and future perspectives for their use in clinical practice.

Non-muscle-invasive bladder cancer (NMIBC) is characterized by a high rate of cure, but also by a non-negligible probability of recurrence and risk progression to muscle-invasive disease. NMIBC management requires a proper local resection and staging, followed by a risk-based treatment with intravesical agents. For many years, the current gold standard treatment for patients with intermediate or high-risk disease is transurethral resection of the bladder (TURB) followed by intravesical bacillus Calmette–Guérin (BCG) instillations. Unfortunately, in about half of high-risk patients, intravesical BCG treatment fails and NMIBC persists or recurs early. While radical cystectomy remains the gold standard for these patients, new therapeutic targets are being individuated and studied. Radical cystectomy in fact can provide an excellent long-term disease control, but can deeply interfere with quality of life. In particular, the enhanced immune checkpoints expression shown in BCG-unresponsive patients and the activity of immune checkpoints inhibitors (ICIs) in advanced bladder cancer provided the rationale for testing ICIs in NMIBC. Recently, pembrolizumab has shown promising activity in BCG-unresponsive NMIBC patients, obtaining FDA approval. Meanwhile multiple novel drugs with alternative mechanisms of action have proven to be safe and effective in NMIBC treatment and others are under investigation. The aim of this review is to analyse and describe the clinical activity of new emerging drugs in BCG-unresponsive NMIBC focusing on immunotherapy results.

Background: Broncho-pulmonary neuroendocrine tumors (bpNETs) are rare malignancies and there is no consensus on therapeutical management of metastatic disease and follow-up after radical resection. Methods: Clinical records of patients with a cytological or histological diagnosis of bpNETs and distant metastases (metachronous or synchronous), evaluated at the European Institute of Oncology between 1997 and 2014, were retrospectively analyzed. Data on patient demographics, pathology, imaging exams, surgical and non-surgical treatments were collected. P value descriptive data, uni- and multi-variate survival analysis were generated for all variables. Results: With a median follow-up of 53 [9–215] months, 61 patients with metachronous and 47 with synchronous metastases were analysed. The most common tool of first recurrence detection was computed tomography. Liver (67%), lymph node (25%), bone (22%) and lung (16%) were the most common sites of relapse. Median time to recurrence was 5 years. Median overall survival (OS) was 72 months for the whole population, with no significant difference between patients with synchronous and metachronous metastases. Age, bone metastases, liver metastases and Ki-67 as a continuous variable all significantly correlated with prognosis at the multivariate analysis. Conclusions: This is one of the largest, single-centre, series of metastatic bpNETs. Among patients with metachronous metastases the pattern of recurrences was heterogeneous as were the follow-up exams used to detect them. The results of our analysis may represent solid bases for designing prospective clinical trials in homogeneous settings of bpNETs.

Ecancermedicalscience is the peer-reviewed open access cancer journal founded by the European Institute of Oncology in Milan. We consider articles on all aspects of research relating to cancer, including molecular biology, genetics, pathophysiology, epide

Objectives: To provide a European-focused overview of the role of patient advocacy groups in shaping surgical lung cancer care, highlighting their contributions to multidisciplinary care, equitable access, psycho-social support, and patient-centred research. Methods: We conducted a narrative review of the major European and national lung cancer advocacy organizations, integrating perspectives from patient leaders and thoracic surgeons. The analysis focused on initiatives directly impacting thoracic surgery and perioperative care, with attention to education, prevention, survivorship, and research advocacy. Results: Multiple advocacy organizations have significantly influenced lung cancer care with relevance to surgery. Oncogene Cancer Research (UK) promotes transparent information and shared decision-making around surgical options across all disease stages. Women Against Lung Cancer in Europe delivers large-scale initiatives such as European Program for ROutine testing of Patients with Advanced lung cancer, expanding molecular testing and psycho-social support across several European countries. The Israeli Lung Cancer Foundation secured national low-dose CT screening and mandatory multidisciplinary team review for early-stage patients. In Greece, FairLife launched the BREATH program, providing structured psycho-social support integrated with surgical pathways. Longkanker Nederland advances shared decision-making through national decision aids, patient-reported outcomes, and guideline development. ALK Positive UK develops tailored education for patients and clinicians, addressing the impact of biomarker status on surgical pathways. At the European level, Lung Cancer Europe drives large-scale surveys, awareness campaigns, and collaborations with European Society of Thoracic Surgery to embed patient perspectives into surgical discussions. Conclusions: Patient advocacy is increasingly shaping thoracic surgery in Europe, bridging gaps in communication, equity, and research. By collaborating with advocacy organizations, surgeons can deliver more integrated, communicative, and patient-centred care, ensuring that surgical innovation aligns with the lived experiences and priorities of patients.