Device-Assisted Therapy in Non-Muscle-Invasive Bladder Cancer

IF 1 4区 医学 Q4 ONCOLOGY
Bladder Cancer Pub Date : 2024-09-14 DOI:10.3233/blc-240032
Sandeep Gurram, Nityam Rathi
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引用次数: 0

Abstract

Intravesical therapy is a critical component in the management of non-muscle-invasive bladder cancer (NMIBC), as it reduces rates of disease recurrence and progression. However, the presence of physiologic barriers in the urothelium reduces the penetration and distribution of intravesical chemotherapy, thereby limiting the therapeutic potential. Much progress to overcome this challenge has been made in the realm of intravesical device-assisted therapy. Novel device-assisted treatments include hyperthermia, the radiofrequency-induced thermochemotherapy effect, electromotive drug administration, and implantable drug delivery systems. Notably, chemotherapy enhanced by these device-assisted systems has shown improved oncologic efficacy relative to standard intravesical chemotherapy and comparable outcomes relative to Bacillus Calmette-Guérin (BCG) therapy in patients with intermediate- or high-risk NMIBC. Recent studies also support the utility of device-assisted therapy as a salvage treatment option in patients with BCG-unresponsive disease. Ongoing randomized controlled trials and prospective investigations will further help clarify indications and long-term safety outcomes of these treatment modalities in NMIBC. Herein, we present a comprehensive review of device-assisted therapies and discuss their clinical utilities for the management of NMIBC in the modern era.

非肌层浸润性膀胱癌的设备辅助疗法
摘要膀胱内治疗是治疗非肌层浸润性膀胱癌(NMIBC)的重要组成部分,因为它能降低疾病的复发率和进展率。然而,尿路上皮细胞中存在的生理屏障降低了膀胱内化疗的渗透和分布,从而限制了治疗潜力。为克服这一难题,膀胱内装置辅助疗法取得了很大进展。新型设备辅助疗法包括热疗、射频诱导热化学疗法效应、电动力给药和植入式给药系统。值得注意的是,在中危或高危 NMIBC 患者中,通过这些设备辅助系统增强化疗的肿瘤疗效优于标准膀胱内化疗,与卡介苗(BCG)疗法的疗效相当。最近的研究还支持将设备辅助疗法作为卡介苗无反应患者的挽救治疗方案。正在进行的随机对照试验和前瞻性研究将进一步帮助明确这些治疗方式在 NMIBC 中的适应症和长期安全性结果。在此,我们对器械辅助疗法进行了全面回顾,并讨论了这些疗法在现代 NMIBC 治疗中的临床实用性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Bladder Cancer
Bladder Cancer Medicine-Urology
CiteScore
1.60
自引率
0.00%
发文量
35
期刊介绍: Bladder Cancer is an international multidisciplinary journal to facilitate progress in understanding the epidemiology/etiology, genetics, molecular correlates, pathogenesis, pharmacology, ethics, patient advocacy and survivorship, diagnosis and treatment of tumors of the bladder and upper urinary tract. The journal publishes research reports, reviews, short communications, and letters-to-the-editor. The journal is dedicated to providing an open forum for original research in basic science, translational research and clinical medicine that expedites our fundamental understanding and improves treatment of tumors of the bladder and upper urinary tract.
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