{"title":"Oncolytic virus therapy for nonmuscle-invasive bladder cancer: current status and future directions.","authors":"Hiroshi Kitamura, Naotaka Nishiyama","doi":"10.1097/MOU.0000000000001331","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose of review: </strong>Nonmuscle-invasive bladder cancer (NMIBC) patients with BCG-unresponsive disease have limited treatment options beyond radical cystectomy. With ongoing BCG shortages and the urgent need for bladder-preserving alternatives, this review examines the emerging role of oncolytic virus therapy as a novel intravesical treatment approach for this challenging patient population.</p><p><strong>Recent findings: </strong>Multiple oncolytic viral platforms have entered clinical trials for NMIBC treatment, demonstrating promising efficacy and safety profiles. Cretostimogene grenadenorepvec has shown exceptional results in a phase 3 trial, achieving 74.5% complete response rates with durable responses exceeding 27 months in BCG-unresponsive carcinoma in situ. Combination therapy with pembrolizumab further enhanced efficacy, with a 57.1% complete response rate at 12 months and no progression to muscle-invasive disease. Other viral platforms, including herpes simplex, coxsackie, and measles viruses, have demonstrated preliminary antitumor activity with favorable safety profiles. These agents utilize three mechanisms of action: selective viral replication, direct oncolysis, and immune system activation.</p><p><strong>Summary: </strong>Oncolytic virus therapy represents a paradigm shift toward an effective bladder-preserving treatment for BCG-unresponsive NMIBC. With phase 3 data supporting regulatory approval pathways, these therapies are poised to become new standards of care, offering hope for improved outcomes while avoiding radical surgery.</p>","PeriodicalId":11093,"journal":{"name":"Current Opinion in Urology","volume":" ","pages":"629-635"},"PeriodicalIF":2.2000,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Current Opinion in Urology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/MOU.0000000000001331","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/9/5 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose of review: Nonmuscle-invasive bladder cancer (NMIBC) patients with BCG-unresponsive disease have limited treatment options beyond radical cystectomy. With ongoing BCG shortages and the urgent need for bladder-preserving alternatives, this review examines the emerging role of oncolytic virus therapy as a novel intravesical treatment approach for this challenging patient population.
Recent findings: Multiple oncolytic viral platforms have entered clinical trials for NMIBC treatment, demonstrating promising efficacy and safety profiles. Cretostimogene grenadenorepvec has shown exceptional results in a phase 3 trial, achieving 74.5% complete response rates with durable responses exceeding 27 months in BCG-unresponsive carcinoma in situ. Combination therapy with pembrolizumab further enhanced efficacy, with a 57.1% complete response rate at 12 months and no progression to muscle-invasive disease. Other viral platforms, including herpes simplex, coxsackie, and measles viruses, have demonstrated preliminary antitumor activity with favorable safety profiles. These agents utilize three mechanisms of action: selective viral replication, direct oncolysis, and immune system activation.
Summary: Oncolytic virus therapy represents a paradigm shift toward an effective bladder-preserving treatment for BCG-unresponsive NMIBC. With phase 3 data supporting regulatory approval pathways, these therapies are poised to become new standards of care, offering hope for improved outcomes while avoiding radical surgery.
期刊介绍:
Current Opinion in Urology delivers a broad-based perspective on the most recent and most exciting developments in urology from across the world. Published bimonthly and featuring ten key topics – including focuses on prostate cancer, bladder cancer and minimally invasive urology – the journal’s renowned team of guest editors ensure a balanced, expert assessment of the recently published literature in each respective field with insightful editorials and on-the-mark invited reviews.