Molecular characterization of plasmacytoid urothelial carcinoma and the impact on treatment implications

•Understanding molecular and genomic aberrations driving the underlying biology of urothelial carcinoma is essential for the development and application of targeted therapies.•Our review illustrates clear differences in the underlying tumor biology between the plasmacytoid variant and conventional urothelial carcinoma.•Possible viable targets include nectin-4 with enfortumab vedotin, the E-cadherin pathway, and the HER2 pathway.