肌肉浸润性膀胱癌围手术期新治疗方法。

IF 2.6 4区 医学 Q2 UROLOGY & NEPHROLOGY
Therapeutic Advances in Urology Pub Date : 2022-10-28 eCollection Date: 2022-01-01 DOI:10.1177/17562872221134389
Goutham Patil, Arnab Basu
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引用次数: 3

摘要

膀胱癌是一个重大的医疗负担,2018年美国有超过1.7万人死于膀胱癌。被诊断为肌肉浸润性膀胱癌(MIBC)的患者具有较高的微转移性疾病发生率,与病变较轻的患者相比,预后差得多。从历史上看,顺铂为基础的手术后新辅助治疗一直是主要的治疗方法。不幸的是,在最初诊断为MIBC的患者中,超过50%的患者不适合传统的顺铂治疗。今天,新的治疗方式,如免疫检查点抑制剂,开始从根本上改善这一人群的预后。在传统化疗的基础上增加免疫检查点治疗似乎可以增加手术期间膀胱的病理完全缓解率。免疫治疗组合也为那些追求非手术治疗的患者提供了新的三合一治疗方法,效果良好。纯免疫治疗方法在新辅助和辅助治疗中显得很有希望,免疫检查点抑制剂nivolumab现在被批准用于高风险患者的辅助治疗。抗体药物偶联物(如enfortumab vedotin)和靶向治疗(如infigratinib)正在围手术期进行试验。这篇综述文章总结了2022年及以后肌肉浸润性膀胱癌治疗的现有证据和可能的未来发展。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Emerging perioperative therapeutic approaches in muscle invasive bladder cancer.

Emerging perioperative therapeutic approaches in muscle invasive bladder cancer.

Emerging perioperative therapeutic approaches in muscle invasive bladder cancer.

Emerging perioperative therapeutic approaches in muscle invasive bladder cancer.

Bladder cancer is a significant healthcare burden with more than 17,000 deaths in the United States in 2018. Patients who are diagnosed with muscle invasive bladder cancer (MIBC) have a high rate of micro-metastatic disease and have a much poorer prognosis compared with patients who have less advanced lesions. Historically, neoadjuvant administration of cisplatin-based therapy followed by surgery has been the mainstay of treatment. Unfortunately, of patients who come in with initially diagnosed MIBC, more than 50% are ineligible for traditional cisplatin-based therapy. Today, new modalities of treatment such as immune checkpoint inhibitors are beginning to radically improve outcomes in this population. The addition of immune checkpoint therapy to traditional chemotherapy appears to augment pathologic complete response rates in the bladder during surgery. Immunotherapy combinations also provide novel trimodality approaches with excellent outcomes in those pursuing non-surgical management. Pure immunotherapy approaches appear promising in the neoadjuvant and adjuvant setting, and the immune checkpoint inhibitor nivolumab is now approved in the adjuvant setting for high-risk patients. Antibody drug conjugates, such as enfortumab vedotin, and targeted therapies, such as infigratinib, are in trials in the perioperative setting. This review article summarizes the current evidence and likely future developments for the management of muscle invasive bladder cancer in 2022 and beyond.

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来源期刊
CiteScore
3.70
自引率
0.00%
发文量
39
审稿时长
10 weeks
期刊介绍: Therapeutic Advances in Urology delivers the highest quality peer-reviewed articles, reviews, and scholarly comment on pioneering efforts and innovative studies across all areas of urology. The journal has a strong clinical and pharmacological focus and is aimed at clinicians and researchers in urology, providing a forum in print and online for publishing the highest quality articles in this area. The editors welcome articles of current interest across all areas of urology, including treatment of urological disorders, with a focus on emerging pharmacological therapies.
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