Poon Darren Ming-Chun
Department of Clinical Oncology, State Key Laboratory of Translational Oncology, Sir YK Pao Centre for Cancer, Hong Kong Cancer Institute and Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong.
Hong Kong Society of Uro-Oncology (HKSUO), Hong Kong.
Asia Pac J Clin Oncol. 2020 Sep;16 Suppl 3:18-23. doi: 10.1111/ajco.13312.
For advanced and metastatic urothelial carcinomas (UCs), platinum (preferably cisplatin)-based chemotherapy has been the standard treatment for many years. However, many patients are ineligible for cisplatin-based chemotherapy because of poor performance status and/or other age-related conditions. At the other end of the spectrum, patients with localized non-muscle-invasive bladder cancer who are unresponsive to intravesical Bacillus Calmette-Guérin (BCG) treatment often face radical cystectomy as the only option. In recent years, the application of immunotherapy in the form of immune-checkpoint inhibitors has provided viable alternatives in the second-line postplatinum and first-line cisplatin-ineligible settings. Recent and ongoing clinical trials are also assessing the safety and efficacy of immunotherapy for neoadjuvant and adjuvant uses before/after cystectomy, for BCG-unresponsive cases, and for combination treatments that include the newer indoleamine 2,3-dioxygenase-1 inhibitors and/or BCG. This review summarizes recent developments in immunotherapy for UCs.
对于晚期和转移性尿路上皮癌（UC），基于铂（最好是顺铂）的化疗多年来一直是标准治疗方法。然而，由于身体状况不佳和/或其他与年龄相关的疾病，许多患者不符合基于顺铂的化疗条件。另一方面，对膀胱内卡介苗（BCG）治疗无反应的局限性非肌层浸润性膀胱癌患者通常面临根治性膀胱切除术这一唯一选择。近年来，以免疫检查点抑制剂形式应用的免疫疗法在铂类化疗后的二线治疗以及一线不适合使用顺铂的情况下提供了可行的替代方案。近期和正在进行的临床试验也在评估免疫疗法在膀胱切除术前/后的新辅助和辅助治疗、对BCG无反应的病例以及包括新型吲哚胺2,3-双加氧酶-1抑制剂和/或BCG的联合治疗中的安全性和有效性。本综述总结了UC免疫疗法的最新进展。
