Teo Min Yuen, Rosenberg Jonathan E
Department of Medicine, Genitourinary Oncology Service, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA.
Department of Medicine, Genitourinary Oncology Service, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA.
Urol Clin North Am. 2018 May;45(2):287-295. doi: 10.1016/j.ucl.2017.12.011.
Neoadjuvant chemotherapy improves survival in patients with muscle-invasive bladder cancer. However, a significant proportion of patients are ineligible for cisplatin owing to renal impairment or other medical comorbidities. The introduction of anti-programmed cell death protein 1/programmed death-ligand 1(PD1/PD-L1) checkpoint inhibitors has redefined the therapeutic landscape for platinum-resistant urothelial cancers; their clinical efficacy and favorable toxicity render these agents attractive therapeutic options either as monotherapy or in combination with other agents in earlier disease states, including muscle-invasive disease. We review potential perioperative immunotherapy strategies, ongoing clinical trials and areas of unmet needs, including upper tract disease and non-urothelial cancers.
新辅助化疗可提高肌肉浸润性膀胱癌患者的生存率。然而，由于肾功能损害或其他合并症，相当一部分患者不符合顺铂治疗条件。抗程序性细胞死亡蛋白1/程序性死亡配体1（PD1/PD-L1）检查点抑制剂的引入重新定义了铂耐药性尿路上皮癌的治疗格局；它们的临床疗效和良好的毒性使这些药物成为有吸引力的治疗选择，无论是作为单一疗法还是与其他药物联合用于早期疾病状态，包括肌肉浸润性疾病。我们综述了潜在的围手术期免疫治疗策略、正在进行的临床试验以及未满足需求的领域，包括上尿路疾病和非尿路上皮癌。
