Targeted therapies for Bacillus Calmette-Guérin unresponsive nonmuscle-invasive bladder cancer: a narrative review.

IF 2.2 3区 医学 Q2 UROLOGY & NEPHROLOGY
Current Opinion in Urology Pub Date : 2025-11-01 Epub Date: 2025-09-18 DOI:10.1097/MOU.0000000000001343
Pierre-Etienne Gabriel, Amir Horowitz, John P Sfakianos, Evanguelos Xylinas
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引用次数: 0

Abstract

Purpose of review: The purpose of this narrative review is to compile the latest available evidence on targeted therapy in the management of Bacillus Calmette-Guérin (BCG)-unresponsive nonmuscle-invasive bladder cancer (NMIBC).

Recent findings: Several recent studies have reported promising results for anti-fibroblast growth factor receptor (FGFR) (erdafitinib) in patients with advanced or metastatic urothelial carcinoma with FGFR alterations. These findings support the exploration of targeted therapies, including tyrosine kinase inhibitors (anti-FGFR and anti-vascular endothelial growth factor (VEGF)), mTOR inhibitors, and EpCAM inhibitors at an earlier stage of the disease to avoid or delay radical cystectomy.

Summary: The THOR-2 study demonstrated promising results for oral Erdafitinib in 73 high-risk BCG-unresponsive pTa/pT1 patients, showing 6 and 12-month recurrence-free survival rates of 96 and 77%, respectively. However, it was associated with notable adverse events (100%, including 22% serious). Other targeted therapies, such as Dovitinib (FGFR inhibitor), Sunitinib (VEGF inhibitor), and Everolimus (mTOR inhibitor), were assessed in three phase II studies, yielding disease-free survival rates between 8 and 44% over 3-12 months. Additionally, in a recent phase 3 trial involving 134 patients with BCG-unresponsive NMIBC, Oportuzumab Monatox (an EpCAM inhibitor) demonstrated a complete response rate of 40% at 3 months and a median response duration of 9.4 months.

卡尔梅特- guerin芽孢杆菌无反应的非肌肉浸润性膀胱癌的靶向治疗:叙述性回顾。
综述目的:本综述的目的是收集针对卡介苗(Bacillus Calmette-Guerin, BCG)无应答的非肌肉浸润性膀胱癌(NMIBC)的靶向治疗的最新证据。最近的一些研究报道了抗成纤维细胞生长因子受体(FGFR)(埃达非替尼)在晚期或转移性尿路上皮癌伴FGFR改变患者中的有希望的结果。这些发现支持靶向治疗的探索,包括酪氨酸激酶抑制剂(抗fgfr和抗血管内皮生长因子(VEGF))、mTOR抑制剂和EpCAM抑制剂在疾病的早期阶段避免或延迟根治性膀胱切除术。总结:THOR-2研究显示口服Erdafitinib治疗73例高危bcg无反应pTa/pT1患者的结果令人鼓舞,6个月和12个月无复发生存率分别为96%和77%。然而,它与显著的不良事件相关(100%,包括22%的严重事件)。其他靶向治疗,如多维替尼(FGFR抑制剂)、舒尼替尼(VEGF抑制剂)和依维莫司(mTOR抑制剂),在三个II期研究中进行了评估,在3-12个月的无病生存率在8%至44%之间。此外,在最近的一项涉及134例bcgs无应答的NMIBC患者的3期试验中,Oportuzumab Monatox(一种EpCAM抑制剂)在3个月时的完全缓解率为40%,中位缓解持续时间为9.4个月。
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
Current Opinion in Urology
Current Opinion in Urology 医学-泌尿学与肾脏学
CiteScore
5.00
自引率
4.00%
发文量
140
审稿时长
6-12 weeks
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.
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