a Medical Oncology & Hemato-oncology , Artemis Hospital , Gurugram , India.
b Medicine, University Hospital del Mar , Barcelona , Spain.
Expert Opin Biol Ther. 2019 Jul;19(7):685-695. doi: 10.1080/14712598.2019.1604673. Epub 2019 May 2.
Successful results of immuno-oncological drugs in metastatic urothelial cancer have triggered the interest of researchers to test them in the non-metastatic setting. Conventional treatment modalities in that space are limited, sometimes toxic and with no improvement seen for the last 20 years and beyond. For patients failing intravesical BCG and mitomycin C in non-muscle invasive bladder cancer, no effective therapeutic alternatives exist besides cystectomy. In the neoadjuvant setting, cisplatin-based chemotherapy provides limited benefit in terms of disease recurrence and metastases, at the expense of toxic effects. The good news is that preliminary studies are showing great promise with the use of immunotherapy in the local and loco-regional disease. Larger studies are now on the way to confirm the exciting potential benefits of immunotherapy in this direction.
This review presents an overview of developments happening on the introduction of immunotherapy in non-metastatic urothelial cancer treatment.
Immunotherapy in the non-metastatic disease setting in urothelial cancer is evolving. Early results tend to anticipate a predominant role in coming times. Large comparative trials are in progress to gather robust practice-changing evidence to bring a paradigm shift in the treatment landscape.
免疫肿瘤药物在转移性尿路上皮癌中的成功结果引发了研究人员的兴趣，促使他们在非转移性环境中对这些药物进行测试。在该领域，常规治疗方法有限，有时具有毒性，并且在过去 20 年及以后没有看到任何改善。对于在非肌肉浸润性膀胱癌中失败的膀胱内卡介苗和丝裂霉素 C 的患者，除了膀胱切除术之外，没有有效的治疗选择。在新辅助治疗环境中，基于顺铂的化疗在疾病复发和转移方面提供了有限的益处，但代价是毒性作用。好消息是，初步研究显示，免疫疗法在局部和局部区域疾病中的应用具有巨大的潜力。目前正在进行更大规模的研究，以证实免疫疗法在这一方向上的令人兴奋的潜在益处。
本文综述了免疫疗法在非转移性尿路上皮癌治疗中的发展情况。
免疫疗法在尿路上皮癌的非转移性疾病环境中正在发展。早期结果倾向于预示着在未来的主导地位。正在进行大型对照试验，以收集强有力的改变实践的证据，从而在治疗领域带来范式转变。
