Systemic Therapy of Urologic Tumors
Systemic therapy is what reaches cancer the knife and the beam cannot — the micrometastases and the disease that has already spread.
The big picture
Systemic therapy is what reaches cancer the knife and the beam cannot — the micrometastases and the disease that has already spread. In urology, three tumour types account for most of it, and each has its signature approach: platinum-based chemotherapy cures most germ-cell tumours and treats bladder cancer, while targeted agents (TKIs) and immunotherapy lead in renal cell carcinoma. The art is matching the right systemic class to the tumour, and knowing the toxicities that define each.
The framework: organise by tumour — germ-cell (BEP), bladder (platinum, neoadjuvant), renal (TKIs/immunotherapy) — and the key drug toxicities.
Mechanism pathway
Tap any step to see why it happens.
Diagnostic algorithm
Each step answers one question. Tap to expand.
Board traps
Germ-cell tumours are cured by cisplatin-based chemo (BEP) — bleomycin → pulmonary fibrosis is the signature toxicity.
Muscle-invasive bladder cancer → neoadjuvant cisplatin-based chemo is standard (before cystectomy).
RCC is chemo-resistant — treat advanced disease with TKIs/immunotherapy, not classic chemotherapy.
TKI toxicity → hypertension (among others); cisplatin → nephro/oto/neurotoxicity.