Sundararajan Srinath, Vogelzang Nicholas J
University of Arizona, Tucson, AZ 85721, USA.
University of Nevada School of Medicine & US Oncology/Comprehensive Cancer Centers of Nevada, Las Vegas, NV 89014, USA.
Future Oncol. 2015;11(16):2299-306. doi: 10.2217/fon.15.162.
Oncologic therapeutics has evolved enormously as we entered the 21st century. Unfortunately, the treatment of advanced urothelial cancer has remained unchanged over the last two decades despite a better understanding of the genetic alterations in bladder cancer. Pathways such as the PI3K/AKT3/mTOR and FGFR have been implicated in urothelial bladder cancer. However, targeted therapies have not shown proven benefit yet and are still considered investigational. Recently, researchers have been successful in manipulating the systemic immune response to mount antitumor effects in melanoma, lung cancer and lymphoma. Historically, intravesical Bacillus Calmette-Guérin immunotherapy has been highly active in nonmuscle invasive bladder cancer. Early data suggest that immune checkpoint inhibitors will soon prove to be another cornerstone in the treatment armamentarium of advanced bladder cancer.
进入21世纪以来，肿瘤治疗学取得了巨大进展。不幸的是，尽管对膀胱癌的基因改变有了更深入的了解，但在过去二十年中，晚期尿路上皮癌的治疗方法却没有变化。PI3K/AKT3/mTOR和FGFR等信号通路与膀胱尿路上皮癌有关。然而，靶向治疗尚未显示出确凿的益处，仍被视为试验性治疗。最近，研究人员已成功操控全身免疫反应，在黑色素瘤、肺癌和淋巴瘤中产生抗肿瘤作用。从历史上看，膀胱内卡介苗免疫疗法在非肌层浸润性膀胱癌中一直具有很高的活性。早期数据表明，免疫检查点抑制剂很快将成为晚期膀胱癌治疗手段中的另一个基石。
