Abstract:
Non-muscle-invasive bladder cancer (NMIBC) encompasses approximately three-quarters of all bladder cancer (BC) diagnoses. Intravesical Bacillus Calmette-Guerin (BCG) has been the long-standing gold standard treatment for patients following endoscopic resection. However, despite reasonable efficacy, recurrence rates are still suboptimal, and this, combined with treatment tolerability and BCG shortages, has prompted an investigation into alternative treatment modalities. Advances in this landscape have been predominantly for patients with BCG-unresponsive disease, and there are currently four FDA-approved treatments for these patients. More recently, trials have emerged looking for alternatives to BCG for patients who are treatment-naïve. We performed a literature search via PubMed to find recent publications on alternatives to BCG, as well as a search on clinicaltrials.gov and recent conference presentations for ongoing clinical trials. Studies have shown that combination intravesical chemotherapy, combination intravesical therapy with BCG, and combination intravenous therapy with BCG preliminarily have good efficacy and safety profiles in this disease space. Ongoing trials are underway, and we anticipate as these studies mature, there will be a shift in NMIBC treatment regimens.
摘要:
非肌肉浸润性膀胱癌(NMIBC)涵盖了所有膀胱癌(BC)诊断的约四分之三。膀胱内卡介苗(BCG)一直是内镜切除术后患者的长期黄金标准治疗方法。然而,尽管疗效合理,复发率仍然不理想,而这个,结合治疗耐受性和卡介苗短缺,促使人们对替代治疗方式进行了调查。这种情况的进展主要是针对BCG无反应疾病的患者,目前有四种FDA批准的治疗方法用于这些患者。最近,已经出现了为未接受治疗的患者寻找BCG替代品的试验。我们通过PubMed进行了文献检索,以查找有关BCG替代品的最新出版物,以及对clinicaltrials.gov的搜索和最近正在进行的临床试验的会议演示。研究表明,联合膀胱内化疗,BCG联合膀胱内治疗,与卡介苗联合静脉治疗在该疾病空间初步具有良好的疗效和安全性。正在进行的审判正在进行中,我们预计随着这些研究的成熟,NMIBC治疗方案将发生变化。