溶瘤病毒治疗非肌肉浸润性膀胱癌:现状和未来方向。

IF 2.2 3区 医学 Q2 UROLOGY & NEPHROLOGY
Current Opinion in Urology Pub Date : 2025-11-01 Epub Date: 2025-09-05 DOI:10.1097/MOU.0000000000001331
Hiroshi Kitamura, Naotaka Nishiyama
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引用次数: 0

摘要

综述的目的:非肌肉浸润性膀胱癌(NMIBC)患者的bcg无反应性疾病,除了根治性膀胱切除术外,治疗选择有限。随着卡介苗的持续短缺和对膀胱保留替代品的迫切需求,本综述探讨了溶瘤病毒治疗作为一种新的膀胱内治疗方法在这一具有挑战性的患者群体中的新作用。最新发现:多种溶瘤病毒平台已进入NMIBC治疗的临床试验,显示出良好的疗效和安全性。Cretostimogene grenadenorepvec在3期试验中显示出优异的结果,在bcg无反应的原位癌中达到74.5%的完全缓解率,持续缓解超过27个月。pembrolizumab联合治疗进一步提高了疗效,12个月的完全缓解率为57.1%,没有进展为肌肉侵袭性疾病。其他病毒平台,包括单纯疱疹病毒、柯萨奇病毒和麻疹病毒,已经显示出初步的抗肿瘤活性和良好的安全性。这些药物利用三种作用机制:选择性病毒复制、直接溶瘤和免疫系统激活。摘要:溶瘤病毒治疗代表了一种有效的保膀胱治疗bcg无反应NMIBC的范式转变。随着iii期数据支持监管批准途径,这些疗法有望成为新的护理标准,在避免根治性手术的同时提供改善结果的希望。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Oncolytic virus therapy for nonmuscle-invasive bladder cancer: current status and future directions.

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.

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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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