Tamalunas Alexander, Schulz Gerald B, Rodler Severin, Apfelbeck Maria, Stief Christian G, Casuscelli Jozefina
Urologische Klinik und Poliklinik, Klinikum der Universität München, Ludwig-Maximilians-Universität München, Marchioninistr. 15, 81377, München, Deutschland.
Urologe A. 2021 Feb;60(2):247-258. doi: 10.1007/s00120-020-01420-5.
With around 30,000 new cases annually bladder cancer (BC) is one of the most frequent cancers in Germany and the incidence is associated with advanced age and nicotine use. Urothelial carcinoma is the most frequent histological variant of BC in Central Europe. Nonmuscle-invasive BC can be resected endourologically and treated with intravesical instillation therapy. In the case of progression to nonmetastatic muscle-invasive disease radical cystectomy with accompanying neoadjuvant or adjuvant chemotherapy can be curative. Systemic treatment is the standard of care in metastatic disease. Although immunotherapy has made great progress in recent years, palliative chemotherapy remains the gold standard in first-line treatment. The armamentarium is continuously evolving: systemic immunotherapy is currently being investigated in nonmuscle-invasive BC as well as in perioperative and maintenance treatment after first-line chemotherapy and several studies are testing new targeted agents in palliative systemic therapy. This article gives an overview of current innovations and the expected paradigm shift in systemic treatment of BC.
每年约有3万例新发病例，膀胱癌（BC）是德国最常见的癌症之一，其发病率与高龄和吸烟有关。尿路上皮癌是中欧最常见的BC组织学类型。非肌层浸润性BC可通过腔内泌尿外科手术切除，并采用膀胱内灌注治疗。如果进展为非转移性肌层浸润性疾病，根治性膀胱切除术联合新辅助或辅助化疗可能治愈。全身治疗是转移性疾病的标准治疗方法。尽管近年来免疫治疗取得了很大进展，但姑息化疗仍然是一线治疗的金标准。治疗手段在不断发展：目前正在非肌层浸润性BC以及一线化疗后的围手术期和维持治疗中研究全身免疫治疗，并且有几项研究正在测试姑息性全身治疗中的新型靶向药物。本文概述了BC全身治疗的当前创新和预期的模式转变。
