Urothelial Carcinoma In Situ: Advances in Diagnosis and Management

IF 2.4 3区医学 Q3 ONCOLOGY

Clinical genitourinary cancer Pub Date : 2026-02-01 Epub Date: 2025-11-29 DOI:10.1016/j.clgc.2025.102478

Gabriele Ricciardi , Pietro Tralongo , Francesco Pierconti , Valeria Zuccalà , Vincenzo Fiorentino , Ludovica Pepe , Mariagiovanna Ballato , Antonio Ieni , Marta Rossanese , Vincenzo Ficarra , Guido Fadda , Maurizio Martini

{"title":"Urothelial Carcinoma In Situ: Advances in Diagnosis and Management","authors":"Gabriele Ricciardi , Pietro Tralongo , Francesco Pierconti , Valeria Zuccalà , Vincenzo Fiorentino , Ludovica Pepe , Mariagiovanna Ballato , Antonio Ieni , Marta Rossanese , Vincenzo Ficarra , Guido Fadda , Maurizio Martini","doi":"10.1016/j.clgc.2025.102478","DOIUrl":null,"url":null,"abstract":"<div><div>Carcinoma in situ (CIS) of the urinary tract is an aggressive, flat, high-grade form of non–muscle-invasive urothelial carcinoma, associated with a high risk of recurrence and progression. Its diagnosis remains challenging due to the absence of specific symptoms and the frequent overlap with benign inflammatory lesions. Although intravesical <em>Bacillus</em> Calmette-Guérin (BCG) remains the standard of care, many patients experience relapse or develop BCG-unresponsive disease, for which effective alternatives are urgently needed. Recent advances in diagnostic techniques, such as narrow band imaging and photodynamic diagnosis, have improved detection accuracy, while novel therapeutic strategies, such as immune checkpoint inhibitors, thermo-chemotherapy, intravescical gene therapy (nadofaragene firadenovec), IL-15 superagonists (eg, ALT-803), and oncolytic viral therapies (eg, CG0070), are expanding the treatment landscape. Furthermore, emerging molecular and immune-related biomarkers may help predict response to therapy and guide personalized management. This review summarizes current evidence on the biology, diagnosis, and treatment of CIS, highlighting key challenges and future directions in the effort to improve patient outcomes and reduce the need for radical cystectomy.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"24 1","pages":"Article 102478"},"PeriodicalIF":2.4000,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical genitourinary cancer","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1558767325001788","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/11/29 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"ONCOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Carcinoma in situ (CIS) of the urinary tract is an aggressive, flat, high-grade form of non–muscle-invasive urothelial carcinoma, associated with a high risk of recurrence and progression. Its diagnosis remains challenging due to the absence of specific symptoms and the frequent overlap with benign inflammatory lesions. Although intravesical Bacillus Calmette-Guérin (BCG) remains the standard of care, many patients experience relapse or develop BCG-unresponsive disease, for which effective alternatives are urgently needed. Recent advances in diagnostic techniques, such as narrow band imaging and photodynamic diagnosis, have improved detection accuracy, while novel therapeutic strategies, such as immune checkpoint inhibitors, thermo-chemotherapy, intravescical gene therapy (nadofaragene firadenovec), IL-15 superagonists (eg, ALT-803), and oncolytic viral therapies (eg, CG0070), are expanding the treatment landscape. Furthermore, emerging molecular and immune-related biomarkers may help predict response to therapy and guide personalized management. This review summarizes current evidence on the biology, diagnosis, and treatment of CIS, highlighting key challenges and future directions in the effort to improve patient outcomes and reduce the need for radical cystectomy.

查看原文本刊更多论文

尿路上皮原位癌的诊断和治疗进展。

尿路原位癌（CIS）是一种侵袭性的、扁平的、高度的非肌肉侵袭性尿路上皮癌，具有复发和进展的高风险。由于缺乏特异性症状和经常与良性炎性病变重叠，其诊断仍然具有挑战性。尽管膀胱内卡介苗（BCG）仍然是标准的治疗方法，但许多患者会复发或发展为卡介苗无反应的疾病，因此迫切需要有效的替代方法。诊断技术的最新进展，如窄带成像和光动力学诊断，提高了检测的准确性，而新的治疗策略，如免疫检查点抑制剂、热化疗、膀胱内基因治疗（nadofaragene firadenovec）、IL-15超级激动剂（如ALT-803）和溶瘤病毒治疗（如CG0070），正在扩大治疗领域。此外，新兴的分子和免疫相关生物标志物可能有助于预测对治疗的反应并指导个性化管理。这篇综述总结了目前关于CIS的生物学、诊断和治疗的证据，强调了改善患者预后和减少根治性膀胱切除术需求的关键挑战和未来方向。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Clinical genitourinary cancer 医学-泌尿学与肾脏学

CiteScore

5.20

自引率

6.20%

发文量

201

审稿时长

54 days

期刊介绍： Clinical Genitourinary Cancer is a peer-reviewed journal that publishes original articles describing various aspects of clinical and translational research in genitourinary cancers. Clinical Genitourinary Cancer is devoted to articles on detection, diagnosis, prevention, and treatment of genitourinary cancers. The main emphasis is on recent scientific developments in all areas related to genitourinary malignancies. Specific areas of interest include clinical research and mechanistic approaches; drug sensitivity and resistance; gene and antisense therapy; pathology, markers, and prognostic indicators; chemoprevention strategies; multimodality therapy; and integration of various approaches.