Targeted and immunotherapy for the management of advanced urothelial carcinoma of the bladder.

IF 2.1 4区 医学 Q3 PHARMACOLOGY & PHARMACY
Robert J Cersosimo
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引用次数: 0

Abstract

Purpose: The activity of targeted and immunotherapy for the management of advanced bladder cancer is reviewed.

Summary: Platinum-based chemotherapy is standard first-line treatment for advanced bladder cancer. Pembrolizumab is approved alone as first-line therapy for patients who are ineligible for any platinum-based chemotherapy and with enfortumab for patients ineligible for cisplatin-based chemotherapy. Avelumab is approved for maintenance therapy in patients who have not progressed with first-line platinum-containing therapy. Pembrolizumab, avelumab, and nivolumab are approved second-line therapy in patients who experience progression during or after platinum-containing chemotherapy. Erdafitinib is indicated for advanced disease that has susceptible FGFR2 or FGFR3 genetic alterations and has progressed during or after treatment with at least one line of platinum-containing chemotherapy. Enfortumab vedotin and sacituzumab govitecan are antibody-drug conjugates. They are both approved for patients who have received anti-PD-L1 or anti-PD-1 therapy and treatment with platinum-containing chemotherapy. Enfortumab is also indicated for patients who are ineligible to receive cisplatin-based therapy and have received one or more prior lines of therapy.

Conclusion: Six targeted and immunotherapeutic agents have been approved for patients with advanced urothelial bladder cancer. They all have demonstrated activity in patients for whom disease has progressed during or after platinum-based therapy. Pembrolizumab, with and without enfortumab, has demonstrated first-line activity, and avelumab is a key maintenance therapy after first-line treatment. The results of additional clinical trials should provide evidence to establish the exact role in therapy of each agent in patients with advanced disease.

治疗晚期膀胱尿路上皮癌的靶向疗法和免疫疗法。
免责声明:为了加快文章的出版速度,AJHP在接受稿件后会尽快在网上发布。被录用的稿件已经过同行评审和校对,但在进行技术格式化和作者校对之前会在网上发布。这些稿件并非最终记录版本,将在稍后时间以最终文章(按AJHP风格排版并由作者校对)取代。目的:综述靶向和免疫疗法在晚期膀胱癌治疗中的作用。摘要:以铂类为基础的化疗是晚期膀胱癌的标准一线治疗方法。Pembrolizumab被批准单独作为一线疗法,用于不符合任何铂类化疗条件的患者;与enfortumab一起用于不符合顺铂类化疗条件的患者。阿维单抗被批准用于一线含铂疗法未见进展的患者的维持治疗。Pembrolizumab、Avelumab和nivolumab被批准用于含铂化疗期间或化疗后病情进展患者的二线治疗。Erdafitinib 适用于存在易感的 FGFR2 或 FGFR3 基因改变、在接受至少一种含铂化疗期间或之后病情进展的晚期疾病。Enfortumab vedotin 和 sacituzumab govitecan 是抗体药物共轭物。它们都被批准用于接受过抗PD-L1或抗PD-1治疗和含铂化疗的患者。恩福珠单抗还适用于不符合顺铂治疗条件且之前接受过一种或多种治疗的患者:六种靶向药物和免疫治疗药物已被批准用于晚期尿路上皮膀胱癌患者。结论:目前已有六种靶向药物和免疫治疗药物获批用于晚期尿路上皮膀胱癌患者的治疗,它们在铂类药物治疗期间或治疗后病情出现进展的患者中均显示出活性。Pembrolizumab(联合或不联合恩福单抗)已显示出一线治疗的活性,而阿维单抗则是一线治疗后的主要维持疗法。更多临床试验的结果将为确定每种药物在晚期疾病患者治疗中的确切作用提供证据。
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来源期刊
CiteScore
2.90
自引率
18.50%
发文量
341
审稿时长
3-8 weeks
期刊介绍: The American Journal of Health-System Pharmacy (AJHP) is the official publication of the American Society of Health-System Pharmacists (ASHP). It publishes peer-reviewed scientific papers on contemporary drug therapy and pharmacy practice innovations in hospitals and health systems. With a circulation of more than 43,000, AJHP is the most widely recognized and respected clinical pharmacy journal in the world.
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