(UroToday.com) As part of the immunotherapy and beyond thematic session at the virtual EAU 2020 meeting, Shahrokh Shariat, MD, discussed whether all urothelial patients should be sequenced. As he notes, urothelial carcinoma is a highly heterogeneous entity and in line with precision medicine, we must select the right therapy, for the right tumor, in the right patient, at the right time. Indeed, urothelial carcinoma is not a monogenic disease and has a complex combination of patient-specific molecular features that drive the development and behavior or each cancer. Whereas urothelial carcinoma may have previously been one disease, today many different forms of urothelial carcinoma are driven by different molecular defects. Therapies will increasingly target the key molecular hubs that drive cancer growth and not just individual mutations. Treatments will become more personalized, taking into account when and how to intervene to hit the right targets, and how treatments are likely to affect each patient. 

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