a Gustave Roussy, Department de Medicine Oncologique & INSERM U981 , Université Paris-Saclay , Villejuif , France.
b Drug Development Department (DITEP), Gustave Roussy , Université Paris-Sud, Université Paris-Saclay , Villejuif , France.
Expert Rev Anticancer Ther. 2018 Apr;18(4):311-318. doi: 10.1080/14737140.2018.1443812. Epub 2018 Mar 5.
Urothelial bladder cancer is one of the most predominant malignancies worldwide with a poor prognosis when presented at an advanced or metastatic stage. Improving the therapeutic landscape in this setting has been an unmet medical need. Palliative cisplatin-based chemotherapy is currently the standard of care in first line therapies, but many patients are ineligible and few alternative therapies exist. Moreover second-line chemotherapy has minimal activity. Recently, immune-checkpoint inhibitors have shifted the therapeutic armamentarium of bladder cancer and it is now necessary to redesign the therapeutic paradigm. Areas covered: In this article, we focus on the development of durvalumab and provide an overview of the safety, activity, efficacy and future perspectives of this drug in urothelial carcinoma. Expert commentary: Durvalumab is a well-tolerated drug and demonstrated major and durable response in advanced bladder cancer. Combinations with durvalumab will probably emerge as promising therapeutic strategies for the treatment of urothelial carcinoma. Further research efforts are needed to identify predictive biomarkers of response to immune-oncology agents.
尿路上皮膀胱癌是全球最主要的恶性肿瘤之一，当其处于晚期或转移阶段时，预后较差。改善这种情况下的治疗前景是未满足的医疗需求。基于顺铂的姑息性化疗目前是一线治疗的标准，但许多患者不符合条件，而且替代疗法很少。此外，二线化疗的活性有限。最近，免疫检查点抑制剂改变了膀胱癌的治疗武器库，现在有必要重新设计治疗模式。涵盖领域：本文重点介绍度伐利尤单抗的开发，并概述该药在尿路上皮癌中的安全性、活性、疗效和未来前景。专家评论：度伐利尤单抗是一种耐受性良好的药物，在晚期膀胱癌中表现出显著和持久的反应。度伐利尤单抗联合用药可能会成为治疗尿路上皮癌有前途的治疗策略。需要进一步研究以确定对免疫肿瘤药物反应的预测性生物标志物。
