Abstract:
UNASSIGNED: To reduce the risk of disease recurrence and progression of intermediate and high-risk Non-Muscle Invasive Bladder Cancers (NMIBCs), intravesical adjuvant treatment with Bacillus Calmette-Guerin (BCG) represents the standard of care, although up to 50% of patients will eventually recur and up to 20% of them will progress to Muscle Invasive Bladder Cancer (MIBC). Radical Cystectomy (RC) is the treatment of choice in this setting; however, this represents a major and morbid surgery, thus meaning that not all NMIBCs patient could undergo or may refuse this procedure or may refuse. The search for effective bladder sparing strategies in NMIBCs BCG-unresponsive patients is a hot topic in the urologic field.
UNASSIGNED: We aimed to review the most important bladder-preserving strategies for BCG unresponsive disease, from those used in the past, even though rarely used nowadays (intravesical chemotherapy with single agents), to current available therapies (e.g. intravesical instillation with Gemcitabine-Docetaxel), and to future upcoming treatments (Oportuzumab Monatox).
UNASSIGNED: At present, bladder-preserving treatments in BCG-unresponsive patients are represented by the use of intravesical instillations, systemic immunotherapies, both with good short-term and modest mid-term efficacy, and numerous clinical trials ongoing, with encouraging initial results, in which patients could be recruited.
摘要:
■为了降低中高危非肌肉浸润性膀胱癌(NMIBCs)的疾病复发和进展的风险,卡介苗(BCG)膀胱内辅助治疗代表了标准的护理,尽管高达50%的患者最终会复发,其中高达20%的患者会进展为肌肉浸润性膀胱癌(MIBC)。根治性膀胱切除术(RC)是在这种情况下选择的治疗方法;然而,这是一个重大而病态的手术,因此意味着并非所有NMIBCs患者都可以接受或可能拒绝此程序或可能拒绝。在NMIBCsBCG无反应的患者中寻找有效的膀胱保留策略是泌尿外科领域的热门话题。
■我们旨在回顾BCG无反应疾病最重要的膀胱保留策略,从过去使用的那些,即使现在很少使用(膀胱内化疗与单一药物),目前可用的治疗方法(例如吉西他滨-多西他赛膀胱灌注),以及未来即将进行的治疗(OportuzumabMonatox)。
■目前,BCG无反应患者的膀胱保留治疗以膀胱内滴注为代表,全身免疫疗法,具有良好的短期和中期疗效,和许多正在进行的临床试验,有了令人鼓舞的初步结果,可以招募患者。