Bladder Cancer最新文献

{"title":"Emerging bladder-sparing treatments for high risk non-muscle invasive bladder cancer.","authors":"Clarissa M Gurbani, Yew-Lam Chong, Zhen Wei Choo, David Chia, Puey Ling Chia, Elise Vong, Sharon Ek Yeo, Zhenbang Liu, Thiruchelvam Jegathesan, Jia-Lun Kwok, Soon Hock Koh, Daniel Zp Yong, Jeffrey J Leow","doi":"10.1177/23523735251348842","DOIUrl":"10.1177/23523735251348842","url":null,"abstract":"<p><p>Bladder cancer (BC) is a significant global health concern, with non-muscle invasive bladder cancer (NMIBC) comprising 75% of cases at diagnosis. High-risk NMIBC (HR-NMIBC) poses a significant therapeutic challenge due to its high recurrence and progression rates despite Bacillus Calmette-Guerin (BCG) therapy. Radical cystectomy remains the gold standard for BCG-unresponsive cases but is often met with considerable morbidity and patient reluctance. This has driven research into alternative bladder-sparing therapies (BSTs). Emerging BSTs include immune checkpoint inhibitors like pembrolizumab and novel agents such as nadofaragene firadenovec and nogapendekin alfa inbakicept (IL-15). These therapies have demonstrated promising response rates in clinical trials, offering potential for disease management while preserving bladder function. Gene therapies and targeted agents like CG0070 and EG-70 are also gaining traction for their innovative mechanisms. However, most data are derived from early-phase, single-arm studies, necessitating larger, randomised trials for validation. Device-assisted strategies, including hyperthermic and electromotive drug delivery systems, show potential to enhance intravesical therapy efficacy. Despite advancements, challenges remain in balancing efficacy, safety, and cost-effectiveness within diverse healthcare settings. This narrative review highlights the evolving landscape of BSTs for HR-NMIBC, emphasising the need for robust clinical evidence to refine patient selection and optimise outcomes.</p>","PeriodicalId":54217,"journal":{"name":"Bladder Cancer","volume":"11 2","pages":"23523735251348842"},"PeriodicalIF":1.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12202947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The importance of maximal TURBT in trimodality therapy for muscle-invasive bladder cancer (MIBC).","authors":"Chris Ho-Ming Wong, Ivan Ching-Ho Ko, David Ka-Wai Leung, Brian Siu, Steffi Kar-Kei Yuen, Jeremy Yuen-Chun Teoh","doi":"10.1177/23523735251346569","DOIUrl":"10.1177/23523735251346569","url":null,"abstract":"<p><p>Trimodality therapy (TMT), consisting of maximal transurethral resection of bladder tumor (TURBT) followed by concurrent chemoradiotherapy, has emerged as a bladder-sparing alternative to radical cystectomy for select patients with muscle-invasive bladder cancer (MIBC). While each component of TMT plays a critical role, maximal TURBT is foundational to its success. This review examines the importance of maximal TURBT in optimizing oncological outcomes in TMT, discusses its technical nuances, and explores the evidence supporting its role in achieving durable local control and improving survival outcomes in MIBC.</p>","PeriodicalId":54217,"journal":{"name":"Bladder Cancer","volume":"11 2","pages":"23523735251346569"},"PeriodicalIF":1.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12165272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of blue light cystoscopy and additional operative evaluations during first surveillance after induction therapy for high-risk NMIBC.","authors":"Ian M McElree, Ryan L Steinberg, Sarah L Mott, Helen Y Hougen, Michael A O'Donnell, Vignesh T Packiam","doi":"10.1177/23523735251324318","DOIUrl":"10.1177/23523735251324318","url":null,"abstract":"<p><strong>Background: </strong>During surveillance of high-risk non-muscle invasive bladder cancer (HR-NMIBC), occult disease can be missed by standard cystoscopy.</p><p><strong>Objective: </strong>To determine the utility of enhanced restaging procedures.</p><p><strong>Methods: </strong>We retrospectively reviewed 297 patients with HR-NMIBC who underwent enhanced restaging procedures during the first surveillance following induction intravesical therapy between 2010-2021. Patients were stratified by number of induction treatments with unique agents (161, 63, and 73 patients with 1, 2, and 3+ treatments) and analyzed using exact logistic regression models. Enhanced restaging procedures included standard cystoscopy (white-light cystoscopy with bladder wash cytology) plus additional components including blue-light cystoscopy, mapping bladder biopsies, retrograde pyelograms, upper tract cytologies, and prostatic urethral biopsies.</p><p><strong>Results: </strong>When standard cystoscopy was negative, blue light cystoscopy detected occult bladder cancer in 6.0%, 7.4%, and 19% of patients in the 1, 2, and 3+ treatment groups. History of CIS was associated with increased detection with blue light (p = 0.03). Extravesical (upper tract or prostatic urethral) cancer was detected by additional restaging components in 0.6%, 1.7%, and 15% of patients with 1, 2, and 3+ intravesical treatments. On multivariable analysis, receipt of 3+ intravesical inductions increased the odds of having at least one additional restaging component identify cancer (HR 3.76; p < .01).</p><p><strong>Conclusions: </strong>Blue light cystoscopy improves surveillance of HR-NMIBC, particularly in those with CIS. Additional restaging procedures improved detection of extravesical disease in patients with heavier pre-treatment history. Risk-adapted utilization of enhanced restaging procedures requires further study.</p>","PeriodicalId":54217,"journal":{"name":"Bladder Cancer","volume":"11 2","pages":"23523735251324318"},"PeriodicalIF":1.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12102550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intravesical instillation of chemotherapy before surgery for upper tract urothelial cancer.","authors":"Edward M Messing, Kamil Malshy","doi":"10.1177/23523735251332755","DOIUrl":"https://doi.org/10.1177/23523735251332755","url":null,"abstract":"","PeriodicalId":54217,"journal":{"name":"Bladder Cancer","volume":"11 2","pages":"23523735251332755"},"PeriodicalIF":1.0,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancements in systemic therapy for muscle-invasive bladder cancer: A systematic review from the beginning to the latest updates.","authors":"Takafumi Yanagisawa, Akihiro Matsukawa, Jeremy Yuen-Chun Teoh, Keiichiro Mori, Tatsushi Kawada, Satoshi Katayama, Paweł Rajwa, Fahad Quhal, Benjamin Pradere, Marco Moschini, Shahrokh F Shariat, Jun Miki, Takahiro Kimura","doi":"10.1177/23523735251335122","DOIUrl":"https://doi.org/10.1177/23523735251335122","url":null,"abstract":"<p><strong>Context: </strong>Several phase III randomized controlled trials (RCTs) have shown the importance of perioperative systemic therapy, especially for the efficacy of immune checkpoint inhibitors (ICIs) in both neoadjuvant and adjuvant settings for muscle-invasive bladder cancer (MIBC).</p><p><strong>Objective: </strong>To synthesize the growing evidence on the efficacy and safety of systemic therapies for MIBC utilizing the data from RCTs.</p><p><strong>Evidence acquisition: </strong>Three databases and ClinicalTrials.gov were searched in October 2024 for eligible RCTs evaluating oncologic outcomes in MIBC patients treated with systemic therapy. We evaluated pathological complete response (pCR), disease-free survival (DFS), progression-free survival (PFS), event-free survival (EFS), overall survival (OS), and adverse events (AEs).</p><p><strong>Evidence synthesis: </strong>Thirty-three RCTs (including 14 ongoing trials) were included in this systematic review. Neoadjuvant chemotherapy improved OS compared to radical cystectomy alone. Particularly, the VESPER trial demonstrated that dd-MVAC provided oncological benefits over GC alone in terms of pCR rates, OS (HR: 0.71), and PFS (HR: 0.70). Recently, the NIAGARA trial showed that perioperative durvalumab plus GC outperformed GC alone in terms of pCR rates, OS (HR: 0.75), and EFS (HR: 0.68). Despite the lack of data on overall AE rates in the VESPER trial, differential safety profiles in hematologic toxicity were reported between dd-MVAC and durvalumab plus GC regimens. In the adjuvant setting, no study provided the OS benefit from adjuvant chemotherapy. However, only adjuvant nivolumab had significant DFS and OS benefits compared to placebo.</p><p><strong>Conclusions: </strong>Neoadjuvant chemotherapy remains the current standard of care for MIBC. Durvalumab shed light on the promising impact of ICIs added to neoadjuvant chemotherapy. Nivolumab is the only ICI recommended as adjuvant therapy in patients who harbored adverse pathologic outcomes. Ongoing trials will provide further information on the impact of combination therapy, including chemotherapy, ICIs, and enfortumab vedotin, in both neoadjuvant and adjuvant settings.</p>","PeriodicalId":54217,"journal":{"name":"Bladder Cancer","volume":"11 2","pages":"23523735251335122"},"PeriodicalIF":1.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144021764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Organoid models in bladder cancer: From bench to bedside?","authors":"Hongda Zhao, Vincy Wing Sze Ho, Kang Liu, Xuan Chen, Hongwei Wu, Peter Ka-Fung Chiu, Lu-Yan Chan, Steffi Kar-Kei Yuen, David Ka-Wai Leung, Alex Qinyang Liu, Chris Ho-Ming Wong, Ivan Ching-Ho Ko, Chi Fai Ng, Dinglan Wu, Jeremy Yuen-Chun Teoh","doi":"10.1177/23523735251330404","DOIUrl":"https://doi.org/10.1177/23523735251330404","url":null,"abstract":"<p><strong>Background: </strong>Bladder cancer (BC), one of the most prevalent and aggressive urological malignancies, poses significant challenges in diagnosis, treatment, and recurrence management. Patient-derived organoid provides new directions for the precision diagnosis and treatment of bladder cancer.</p><p><strong>Objective: </strong>To make a comprehensive summary of the current bladder cancer organoid studies.</p><p><strong>Methods: </strong>A comprehensive database search was conducted to provide an in-depth overview of the current state of bladder cancer organoid models, with a focus on their applications in basic research, clinical translation, and therapeutic discovery.</p><p><strong>Results: </strong>We summarized the current bladder cancer organoid studies, highlighting their advantages, such as genetic fidelity and high-throughput drug screening capabilities. Additionally, we also address the challenges, including their limited representation of the tumour microenvironment and technical complexity. Finally, we discuss future directions, including the integration of immunotherapy, the development of co-culture systems, and the exploration of non-invasive sampling methods and organoid-on-chip systems.</p><p><strong>Conclusions: </strong>Traditional pre-clinical models have inherent limitations in mimicking the complexity of human tumours. The emergence of organoid technology has offered a groundbreaking approach to address this challenge, providing an innovative tool for studying tumour biology, genetic alterations, drug screening, and personalized medicine in bladder cancer.</p>","PeriodicalId":54217,"journal":{"name":"Bladder Cancer","volume":"11 2","pages":"23523735251330404"},"PeriodicalIF":1.0,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12033766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Higher resilience in radical cystectomy patients is associated with improved health related quality of life post-operatively.","authors":"Lauren N Kennedy, Caleb S Miller, Danica N May, Evan Fruhauf, Hadley W Wyre, Moben Mirza, Junqiang Dai, Jeffrey M Holzbeierlein, Hayley Stolzle, Moira Mulhern, Mihaela E Sardiu, Eugene K Lee","doi":"10.1177/23523735251319180","DOIUrl":"https://doi.org/10.1177/23523735251319180","url":null,"abstract":"<p><strong>Background: </strong>Radical cystectomy (RC) with urinary diversion (UD) is associated with substantial morbidity. Enhanced recovery after surgery protocols, increased robotic usage, and improvements in urinary diversion have been evaluated for their effects on health-related Quality of Life (HRQoL), however, results are mixed. How psychosocial traits inherent to the patient influence HRQoL outcomes is unknown in this population.</p><p><strong>Objective: </strong>This study aimed to evaluate resilience and its correlation with HRQoL in a cohort of patients undergoing RC for bladder cancer.</p><p><strong>Methods: </strong>Patients with bladder cancer undergoing RC with UD at the University of Kansas Medical Center were screened for prospective enrollment in this clinical trial (NCT06337305). The validated Connor-Davidson Resilience Scale 25 (CD-RISC), the Functional Assessment of Cancer Therapy-Bladder-Cystectomy (FACT-BL-Cys), and the PROMIS 29-v2.0 were administered preoperatively, 2-3 weeks postoperatively, and at 90 days postoperatively. Patient demographics, pathology, and complication data were collected.</p><p><strong>Results: </strong>Between November 2020 and August 2022, 52 patients completed the survey data. Patients were stratified based on baseline resilience score. The higher resilience group scored 85.7, 85.0, and 81.9 compared to 64.9, 70.4, and 72.0 at the three time points which all remained statistically significant. Participant resilience scores using the CD-RISC did not correlate with quality-of-life measures using the PROMIS or FACT-Bl-Cys at baseline or two weeks but did correlate at 90 days (p < 0.01). Resilience did not correlate with the patient's pathology stage or 90-day complication data.</p><p><strong>Conclusions: </strong>Patients with higher baseline resilience maintain higher levels throughout the perioperative period and correlate with QOL.</p>","PeriodicalId":54217,"journal":{"name":"Bladder Cancer","volume":"11 2","pages":"23523735251319180"},"PeriodicalIF":1.0,"publicationDate":"2025-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12033614/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical trials corner issue 11(1).","authors":"Piyush K Agarwal, Cora N Sternberg","doi":"10.1177/23523735241309418","DOIUrl":"https://doi.org/10.1177/23523735241309418","url":null,"abstract":"","PeriodicalId":54217,"journal":{"name":"Bladder Cancer","volume":"11 1","pages":"23523735241309418"},"PeriodicalIF":1.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Platinum-based chemotherapy rechallenge or enfortumab vedotin after maintenance avelumab or pembrolizumab for locally advanced or metastatic urothelial carcinoma.","authors":"Nobutaka Nishimura, Makito Miyake, Norimi Takamatsu, Kosuke Mieda, Kuniaki Inoue, Akira Tachibana, Keichi Sakamoto, Mikiko Onishi, Fumisato Maesaka, Takanosuke Yoshikawa, Mitsuru Tomizawa, Takuto Shimizu, Kenta Onishi, Shunta Hori, Yosuke Morizawa, Daisuke Gotoh, Yasushi Nakai, Nobumichi Tanaka, Kiyohide Fujimoto","doi":"10.1177/23523735251317423","DOIUrl":"10.1177/23523735251317423","url":null,"abstract":"<p><strong>Background: </strong>In current clinical practice, the use of switch maintenance avelumab is recommended for patients with locally advanced and metastatic urothelial carcinoma who experience favorable responses to first-line chemotherapy.</p><p><strong>Objective: </strong>We aimed to evaluate the potential advantages of platinum-based chemotherapy (Pl-CT) rechallenge after maintenance avelumab.</p><p><strong>Methods: </strong>A retrospective analysis involving 383 patients treated with first-line Pl-CT between 2015 and 2023 was conducted. Subsequent treatment strategies included Pl-CT or enfortumab vedotin (EV) following maintenance avelumab or pembrolizumab, and their benefit was evaluated.</p><p><strong>Results: </strong>Pl-CT rechallenge following maintenance avelumab did not show significant benefits, demonstrating lower response rates and shorter progression-free survival compared to EV. Conversely, both Pl-CT and EV following pembrolizumab showed similar efficacy.</p><p><strong>Conclusions: </strong>These findings suggest that in the current clinical landscape, EV might be a more preferable option than Pl-CT rechallenge subsequent to avelumab maintenance therapy, thereby influencing treatment decisions for metastatic urothelial carcinoma.</p>","PeriodicalId":54217,"journal":{"name":"Bladder Cancer","volume":"11 1","pages":"23523735251317423"},"PeriodicalIF":1.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11926830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Standard vs extended lymphadenectomy for muscle invasive bladder cancer.","authors":"Edward M Messing","doi":"10.1177/23523735251314984","DOIUrl":"10.1177/23523735251314984","url":null,"abstract":"","PeriodicalId":54217,"journal":{"name":"Bladder Cancer","volume":"11 1","pages":"23523735251314984"},"PeriodicalIF":1.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11926826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}