Section of Urology, Department of Surgery, University of Chicago Medical Center, Chicago, Illinois.
Cancer. 2017 Feb 1;123(3):390-400. doi: 10.1002/cncr.30392. Epub 2016 Nov 2.
An unmet need exists for patients with high-risk non-muscle-invasive bladder cancer for whom bacille Calmette-Guérin (BCG) has failed and who seek further bladder-sparing approaches. This shortcoming poses difficult management dilemmas. This review explores previously investigated first-line intravesical therapies and discusses emerging second-line treatments for the heterogeneous group of patients for whom BCG has failed. The myriad of recently published and ongoing trials assessing novel salvage intravesical treatments offer promise to patients who both seek an effective cure and want to avoid radical surgery. However, these trials must carefully be contextualized by specific patient, tumor, and recurrence characteristics. As data continue to accumulate, there will potentially be a role for these agents as second-line or even first-line intravesical therapies. Cancer 2017;123:390-400. © 2016 American Cancer Society.
对于卡介苗（BCG）治疗失败且寻求进一步保留膀胱的高危非肌肉浸润性膀胱癌患者，存在未满足的需求。这一缺陷带来了困难的管理难题。本综述探讨了先前研究的一线膀胱内治疗方法，并讨论了用于 BCG 治疗失败的异质患者群体的新兴二线治疗方法。最近发表的大量临床试验评估了新型挽救性膀胱内治疗方法，为那些既寻求有效治疗又希望避免根治性手术的患者带来了希望。然而，这些试验必须根据具体的患者、肿瘤和复发特征进行仔细的上下文分析。随着数据的不断积累，这些药物可能会作为二线甚至一线膀胱内治疗方法发挥作用。癌症 2017；123:390-400。©2016 美国癌症协会。
