Kramer M W, Gakis G
Klinik für Urologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Lübeck, Deutschland.
Klinik und Poliklinik für Urologie und Kinderurologie, Universitätsklinikum Würzburg, Oberdürrbacher Straße 6, 97080, Würzburg, Deutschland.
Urologe A. 2020 Jul;59(7):784-789. doi: 10.1007/s00120-020-01233-6.
High-risk nonmuscle invasive bladder cancer (HR NMIBC) is an immunological malignancy. The standard therapy for HR NMIBC is based on transurethral bladder tumor resection with adjuvant Bacillus Calmette Guérin (BCG) instillation therapy. To prevent progression in case of BCG-refractory disease, early radical cystectomy is considered the therapy of choice according to the German S3 guidelines. With the advent of checkpoint inhibitors for the treatment of metastatic urological malignancies, a novel option for bladder preservation has been introduced for the treatment of HR NMIBC. The currently available data do not allow a meaningful conclusion on the long-term efficacy of PD-(L)1 (programmed cell death [ligand] 1) inhibitors due to the relatively short duration of oncological follow-up. Yet, it can be expected that checkpoint inhibitors will change the treatment algorithm of HR NMIBC in the next few years. Promising studies have been initiated to test the combination of local and systemic immunomodulation in terms of response and toxicity.
高危非肌层浸润性膀胱癌（HR NMIBC）是一种免疫性恶性肿瘤。HR NMIBC的标准治疗方法是经尿道膀胱肿瘤切除术并辅助卡介苗（BCG）灌注治疗。为防止卡介苗难治性疾病进展，根据德国S3指南，早期根治性膀胱切除术被视为首选治疗方法。随着用于治疗转移性泌尿生殖系统恶性肿瘤的检查点抑制剂的出现，一种用于治疗HR NMIBC的膀胱保留新选择被引入。由于肿瘤学随访时间相对较短，目前可用的数据无法就PD-（L）1（程序性细胞死亡[配体]1）抑制剂的长期疗效得出有意义的结论。然而，可以预期，在未来几年，检查点抑制剂将改变HR NMIBC的治疗方案。已经开展了有前景的研究来测试局部和全身免疫调节联合治疗的反应和毒性。
