Department of Urology, King's College Hospital, London, UK.
Expert Rev Anticancer Ther. 2009 Dec;9(12):1777-82. doi: 10.1586/era.09.106.
Bladder cancer is the second most common urological malignancy with a one in 28 lifetime risk. Three-quarters of tumors are non-muscle-invasive (formerly termed superficial) at the time of presentation. Approximately half of all non-muscle-invasive bladder cancer (NMIBC) will recur and, depending on certain prognostic factors including grade, stage and presence of carcinoma in situ, a number will progress to muscle invasion. The standard of care for NMIBC is transurethral resection of bladder tumor (TURBT) to remove the mass lesion(s). Intravesical therapy of NMIBC post-TURBT therefore aims to delay/prevent recurrence and/or progression to muscle-invasive bladder cancer. While intravesical chemotherapy, such as mitomycin C, and immunotherapy, such as bacillus Calmette-Guérin are well established, there is current interest in novel therapies based on improved molecular understanding of bladder cancer. These novel therapies include gene therapy, using viral and non-viral vectors for transfer, monoclonal antibodies and direct tumoricidal viruses. While there is a sound theoretical basis for these therapies based on molecular targeting, there is little evidence in human studies that these therapies have clinical impact on NMIBC. However, it is certain that their use will be investigated further and they provide great hope for the future of NMIBC adjuvant therapy.
膀胱癌是第二大常见的泌尿系统恶性肿瘤，其终生发病风险为 1/28。四分之三的肿瘤在出现时为非肌肉浸润性（以前称为浅表性）。大约一半的非肌肉浸润性膀胱癌（NMIBC）会复发，并且根据某些预后因素，包括分级、分期和原位癌的存在，一些会进展为肌肉浸润性。NMIBC 的标准治疗方法是经尿道膀胱肿瘤切除术（TURBT）切除肿块。因此，TURBT 后对 NMIBC 的膀胱内治疗旨在延迟/预防复发和/或进展为肌肉浸润性膀胱癌。虽然已经确立了经尿道膀胱内化疗（如丝裂霉素 C）和免疫疗法（如卡介苗），但目前对基于膀胱癌分子理解的新型疗法（包括基因疗法，使用病毒和非病毒载体进行转移、单克隆抗体和直接杀伤肿瘤病毒）感兴趣。虽然这些疗法基于分子靶向具有合理的理论基础，但在人类研究中几乎没有证据表明这些疗法对 NMIBC 具有临床影响。然而，可以肯定的是，它们的使用将进一步得到研究，它们为 NMIBC 辅助治疗的未来提供了巨大的希望。
