Department of Urology, MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1373, Houston, Texas 77054, USA.
Department of Urology, Claude Bernard University, Hôpital Edouard Herriot, Urologie - Pavillon V, 5 Place d'Arsonval, 69003 Lyon, France.
Nat Rev Urol. 2017 Apr;14(4):244-255. doi: 10.1038/nrurol.2017.16. Epub 2017 Feb 21.
Intravesical immunotherapy with live attenuated BCG remains the standard of care for patients with high-risk and intermediate-risk non-muscle-invasive bladder cancer (NMIBC). Most patients initially respond, but recurrence is frequent and progression to invasive cancer is a concern. No established and effective intravesical therapies are available for patients whose tumours recur after BCG, representing a clinically important unmet need. Development and discovery of treatment options for BCG-unresponsive NMIBC is a high priority in order to decrease the morbidity, burden of health-care expenditures, and mortality related to bladder cancer. This Review of treatment options after BCG failure focuses on principles of optimal management emerging therapies, thus enabling a synthesis of recommendations for management for such patients.
经尿道免疫治疗采用活的减毒卡介苗仍然是高危和中危非肌肉浸润性膀胱癌（NMIBC）患者的标准治疗方法。大多数患者最初有反应，但复发频繁，进展为浸润性癌令人担忧。对于卡介苗治疗后肿瘤复发的患者，尚无既定和有效的经尿道治疗方法，这是临床上未满足的重要需求。为了降低膀胱癌相关发病率、医疗支出负担和死亡率，开发和发现针对卡介苗无反应性 NMIBC 的治疗选择是当务之急。本综述聚焦于卡介苗治疗失败后的治疗选择原则和新兴疗法，从而为这类患者的治疗提供了综合建议。
