U-CHANGE Project: a multidimensional consensus on how clinicians, patients and caregivers may approach together the new urothelial cancer scenario.

Advanced urothelial carcinoma remains aggressive and very hard to cure, while new treatments will pose a challenge for clinicians and healthcare funding policymakers alike. The U-CHANGE Project aimed to redesign the current model of care for advanced urothelial carcinoma patients to identify limitations ("as is" scenario) and recommend future actions ("to be" scenario). Twenty-three subject-matter experts, divided into three groups, analyzed the two scenarios as part of a multidimensional consensus process, developing statements for specific domains of the disease, and a simplified Delphi methodology was used to establish consensus among the experts. Recommended actions included increasing awareness of the disease, increased training of healthcare professionals, improvement of screening strategies and care pathways, increased support for patients and caregivers and relevant recommendations from molecular tumor boards when comprehensive genomic profiling has to be provided for appropriate patient selection to While the innovative new targeted agents have the potential to significantly alter the clinical approach to this highly aggressive disease, the U-CHANGE Project experience shows that the use of these new agents will require a radical shift in the entire model of care, implementing sustainable changes which anticipate the benefits of future treatments, capable of targeting the right patient with the right agent at different stages of the disease.

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Copyright © 2023 Bracarda, Iacovelli, Baldazzi, Zucali, Gernone, Conti, Pappagallo, Brunelli, Bruzzi, Fiorini, Magenta, Diomede, Mereta, D’Aria, Magliano, Liberatori, Cantù, Croce, Eandi, Colombo, Ferrante, Salè, Marinozzi, Lenzi, Remiddi and Remiddi.

Déclaration de conflit d'intérêts

GLC has received speaker fees, research and educational grants from Abbott, Boehringer Ingelheim, Eli Lilly, Novo Nordisk, Sanofi and Pfizer. GNC has received speaker fees, research and educational grants from Janssen, Astellas, Bayer, Recordati, MSD, Astrazeneca, IPSEN. VB has received speakers fees from Janssen and Astellas. PB has received speaker fees, research and educational grants from Astellas, Astrazeneca, BeiGene, Dephaforum, EISAI, Eli Lilly, Excerptamedica, Gilead, Janssen-Cilag SpA, Merck Serono Spa, MSD, Novartis, PierreFabre, Pharmagenesis, Reithera srl, Roche, Rottapharm, Sanofi, Servier, Takeda, Takis, and Toscana Life Science. Outside of the submitted work, PZ reports personal fees for advisory roles, speaker engagements and travel and accommodation expenses from MSD, Merck Serono Spa, Astellas, Janssen-Cilag SpA, Sanofi, Ipsen, Pizer, Noartis, BMS, Amgen, AstraZeneca, Roche and Bayer. SB was advisory board or Steering Committee Member uncompensated for: Bayer, Astellas, Janssen, Pfizer, BMS, Roche, Ipsen, MSD, AAA, Sanofi, Merck, Astrazeneca. GP reports fees as advisory board and expertise dossier on clinical-epidemiological evaluations for Astellas, BMS, Merck, MSD. RI served as an advisory board member or consultant for Astellas, Pfizer, Janssen, Sanofi, IPSEN, MSD, BMS, Novartis, EISAI; received institutional support for research project from Pfizer and BMS. AG has received speakers fees from Amgen. MB received research grants and speaker fees from MSD, Leica and speaker fees from Pfizer. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The reviewer SL declared a shared affiliation with the author EOS to the handling editor at the time of review.