ArticleEuropean urology open science2026
Expression of NECTIN-4 and TROP-2 in Resected Upper Tract Urothelial Carcinoma with and Without Preoperative Chemotherapy.
Article in European urology open science, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Antibody-drug conjugates (ADCs) have transformed the treatment of urothelial carcinoma, yet upper tract urothelial cancer (UTUC) data remain limited. Objective: We compared NECTIN-4 and trophoblast cell-surface antigen 2 (TROP-2) expression in UTUC specimens from treatment-naive (TN) and chemotherapy (CTX)-exposed patients. Design setting and participants: A retrospective cohort of 141 consecutive patients with UTUC who underwent resection from 1991 to 2021 was stratified into TN and CTX-exposed cohorts. Outcome measurements and statistical analysis: Tissue microarrays were stained for NECTIN-4 and TROP-2 and quantified using the H-score method, with H-score ≥15 and ≥10 defining positivity, respectively. Group comparisons were performed using Wilcoxon rank-sum and Fisher exact tests. Results and limitations: NECTIN-4 membrane positivity was observed in 47% (25/53) and 9.3% (8/86) of TN and CTX-exposed specimens, respectively ( Conclusions: TROP-2 expression was near universal regardless of CTX exposure, including patients who developed recurrence, whereas NECTIN-4 expression was significantly lower in CTX-exposed cohorts. These findings support TROP-2 as a more durable ADC target in UTUC, warranting further investigation of TROP-2-directed ADCs, particularly with prior CTX exposure.
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