Medical Oncology Department, Hospital del Mar, IMIM (Hospital del Mar Research Institute), Barcelona, Spain.
Medical Oncology Department, Clinica Universidad de Navarra, Pamplona, Spain.
Clin Cancer Res. 2018 Dec 15;24(24):6115-6124. doi: 10.1158/1078-0432.CCR-17-3108. Epub 2018 Jul 10.
Immune checkpoint inhibitors (ICI) have emerged as a novel therapeutic strategy that achieves significant clinical benefit in several tumor types, including urothelial cancer. Overall, these agents have shown objective response rates of around 20% to 23%, which indicates that a significant proportion of patients do not benefit from immunotherapy when given as monotherapy. Moreover, despite an initial response to therapy and an improvement in the median duration of response compared with chemotherapy, still only half of the patients develop long-term maintained remissions. Active research is ongoing in several fields, aiming to increase the number of patients that benefit from ICI, and this research is largely based on the development of biomarkers for personalized immunotherapy and novel combinations of ICI with other agents. This article will review ongoing efforts to develop combinations of ICI with other therapeutic strategies in patients with urothelial cancer, including chemotherapy, targeted agents, other immunotherapy strategies, and radiotherapy.
免疫检查点抑制剂（ICI）已成为一种新的治疗策略，在包括膀胱癌在内的多种肿瘤类型中取得了显著的临床获益。总的来说，这些药物在单药治疗时的客观缓解率约为 20%至 23%，这表明相当一部分患者不能从免疫治疗中获益。此外，尽管与化疗相比，治疗后有初始反应，且反应持续时间的中位数有所改善，但仍只有一半的患者出现长期持续缓解。目前正在多个领域开展积极的研究，旨在增加受益于 ICI 的患者数量，而这些研究主要基于为个体化免疫治疗和 ICI 与其他药物联合使用开发生物标志物。本文将综述目前在膀胱癌患者中开发 ICI 与其他治疗策略联合使用的努力，包括化疗、靶向药物、其他免疫治疗策略和放疗。
