膀胱内化疗联合治疗bcg无反应的非肌肉浸润性膀胱癌。

IF 2.1 3区 医学 Q2 UROLOGY & NEPHROLOGY
Paolo Zaurito, Pietro Scilipoti, Francesco Montorsi, Alberto Briganti, Marco Moschini
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引用次数: 0

摘要

综述目的:对于卡介苗-谷氨酰胺无反应(U-BCG)非肌肉浸润性膀胱癌(NMIBC)患者,开发膀胱保留疗法(BSTs)作为根治性膀胱切除术(RC)的替代方案的兴趣越来越大。我们的目的是根据最新的证据,对U-BCG NMIBC患者膀胱内化疗联合治疗的有效性和安全性进行综述。近期研究发现:膀胱内化疗联合治疗U-BCG患者已显示出良好的疗效和耐受性,特别是在回顾性研究中。对于U-BCG患者,在这种情况下最常用的选择是膀胱内注射吉西他滨加多西他赛,根据最近的报道,2年无复发生存率在37-62%之间,2年无进展生存率为70-95%,3-5级不良事件(ae)在3-8%之间变化。其他研究正在调查两种以上化疗药物的联合使用,最近的一项前瞻性试验显示,三种膀胱内药物(吉西他滨、卡巴他赛、顺铂)联合使用的结果令人鼓舞,1年无膀胱切除术生存率为97%,中位随访20个月无3-5级ae的证据。摘要:最近关于U-BCG NMIBC的膀胱内化疗联合治疗的证据主要基于回顾性研究,特别是吉西他滨/多西他赛的研究。然而,一些研究目前正在研究两种以上化疗药物的联合使用。总体而言,研究显示U-BCG NMIBC患者短期疗效良好,疾病进展率可接受,耐受性良好。然而,需要前瞻性研究来支持在卡介苗治疗失败的患者中广泛使用新的bst作为RC的有效替代方案。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Intravesical chemotherapy combination treatments for BCG-unresponsive nonmuscle invasive bladder cancer.

Purpose of review: There is an increasing interest in developing bladder sparing therapies (BSTs) for patients with Bacillus Calmette-Guérin unresponsive (U-BCG) nonmuscle invasive bladder cancer (NMIBC) as an alternative to radical cystectomy (RC). We aimed to perform a review of efficacy and safety of intravesical chemotherapy combination treatments for U-BCG NMIBC patients according to the most recent evidence.

Recent findings: The use of intravesical chemotherapy combination treatments for U-BCG patients has shown promising efficacy and tolerability especially in retrospective series. For U-BCG patients, the most used option in this context is intravesical gemcitabine plus docetaxel, with a 2-year recurrence free-survival ranging between 37-62%, and a 2-year progression free-survival rate of 70-95%, with grade 3-5 adverse events (AEs) varying between 3-8% according to the most recent reports. Other studies are investigating the combination of more than two chemotherapy agents, with a recent prospective trial showing encouraging results for the combination of three intravesical drugs (gemcitabine, cabazitaxel, cisplatin) with a cystectomy-free survival rate of 97% at 1-year and no evidence of grade 3-5 AEs at a median follow-up of 20 months.

Summary: Recent evidence on intravesical chemotherapy combination treatment for U-BCG NMIBC is mostly based on retrospective studies, especially those investigating gemcitabine/docetaxel. However, some studies are currently investigating the combination of more than two chemotherapy agents. Overall, studies show good short-term efficacy, acceptable rates of disease progression, and tolerability in patients with U-BCG NMIBC. Nevertheless, prospective studies will be needed to support the widespread use of new BSTs as valid alternatives to RC in patients who failed BCG.

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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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