Department of Clinical Therapeutics, Medical School, University of Athens, 80 Vasilissis Sofias Ave, Athens, Greece.
Expert Rev Anticancer Ther. 2011 Jun;11(6):931-9. doi: 10.1586/era.10.197.
Advanced transitional-cell carcinoma of the bladder is the most common cancer of the urinary tract, with a high mortality rate. Cisplatin-based chemotherapy has demonstrated prolonged survival of these patients and is considered the standard of care. Nevertheless, 40-50% of patients have impaired renal function that precludes the use of cisplatin. The non-nephrotoxic platinum analogue, carboplatin, has emerged as the most popular alternative in this setting, used mainly in doublets. However, it has not shown similar efficacy to cisplatin. In this article, platinum-based or platinum-free regimens, monotherapies or combination therapies are discussed as treatment options for this population. Their efficacy and toxicity are also being analyzed. The study of newer targeted therapies in the treatment of bladder cancer is also discussed, as are future perspectives and a five-year view in the treatment of the disease in patients with renal impairment.
高级移行细胞膀胱癌是最常见的泌尿道癌症，死亡率高。顺铂为基础的化疗已证实能延长这些患者的生存时间，被认为是标准的治疗方法。然而，40-50%的患者存在肾功能受损，无法使用顺铂。非肾毒性的铂类似物卡铂已成为该治疗环境中最受欢迎的替代药物，主要用于双药联合治疗。然而，它的疗效并不像顺铂那样好。在本文中，讨论了基于铂类或无铂类方案、单药治疗或联合治疗作为该人群的治疗选择。还分析了它们的疗效和毒性。还讨论了在膀胱癌治疗中使用新型靶向治疗的研究，以及对肾功能受损患者的疾病治疗的未来展望和五年看法。
