Division of Medical Oncology, Department of Oncology, Mayo Clinic, Rochester, MN.
Division of Medical Oncology, Department of Oncology, Mayo Clinic, Rochester, MN.
Mayo Clin Proc. 2017 Oct;92(10):1564-1582. doi: 10.1016/j.mayocp.2017.07.010.
The incidence of bladder cancer has increased in the past decade, and mortality from bladder cancer remains a substantial public health burden. After 3 decades of minimal progress in the treatment of advanced-stage disease, recent advances in the genomic characterization of urothelial cancer and breakthroughs in bladder cancer therapeutics have rejuvenated the field. This review highlights the landmark clinical trials of chemotherapy in both the neoadjuvant and advanced or metastatic urothelial carcinoma settings. We describe treatment paradigms for multimodal treatment of locally advanced bladder cancer, including discussion on bladder preservation strategies. Lastly, we discuss novel immunomodulatory, targeted, and combination therapies in development for the treatment of advanced urothelial carcinoma.
在过去的十年中，膀胱癌的发病率有所增加，膀胱癌的死亡率仍然是一个重大的公共卫生负担。在晚期疾病的治疗方面取得了 30 年的微小进展之后，最近在尿路上皮癌的基因组特征描述和膀胱癌治疗方面的突破为该领域带来了新的活力。这篇综述重点介绍了新辅助和晚期或转移性尿路上皮癌治疗中化疗的标志性临床试验。我们描述了局部晚期膀胱癌的多模式治疗方案，包括对膀胱保存策略的讨论。最后，我们讨论了正在开发用于治疗晚期尿路上皮癌的新型免疫调节、靶向和联合疗法。
