Shih Kuan-Wei, Chen Wei-Chieh, Chang Ching-Hsin, Tai Ting-En, Wu Jeng-Cheng, Huang Andy C, Liu Ming-Che
1Department of Urology, Taipei Medical University Hospital, Taipei 11031, Taiwan.
2Graduate Institute of Clinical Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan.
Aging Dis. 2021 Jun 1;12(3):868-885. doi: 10.14336/AD.2020.1109. eCollection 2021 Jun.
Non-muscular invasive bladder cancer (NMIBC) is one of the most common cancer and major cause of economical and health burden in developed countries. Progression of NMIBC has been characterized as low-grade (Ta) and high grade (carcinoma in situ and T1). The current surgical intervention for NMIBC includes transurethral resection of bladder tumor; however, its recurrence still remains a challenge. The BCG-based immunotherapy is much effective against low-grade NMIBC. BCG increases the influx of T cells at bladder cancer site and inhibits proliferation of bladder cancer cells. The chemotherapy is another traditional approach to address NMIBC by supplementing BCG. Notwithstanding, these current therapeutic measures possess limited efficacy in controlling NMIBC, and do not provide comprehensive long-term relief. Hence, biomaterials and scaffolds seem an effective medium to deliver therapeutic agents for restructuring bladder post-treatment. The regenerative therapies such as stem cells and PRP have also been explored for possible solution to NMIBC. Based on above-mentioned approaches, we have comprehensively analyzed therapeutic journey from traditional to regenerative interventions for the treatment of NMIBC.
非肌层浸润性膀胱癌(NMIBC)是发达国家最常见的癌症之一,也是造成经济和健康负担的主要原因。NMIBC的进展分为低级别(Ta)和高级别(原位癌和T1)。目前针对NMIBC的手术干预包括经尿道膀胱肿瘤切除术;然而,其复发仍然是一个挑战。基于卡介苗的免疫疗法对低级别NMIBC非常有效。卡介苗可增加膀胱癌部位T细胞的流入,并抑制膀胱癌细胞的增殖。化疗是通过补充卡介苗来治疗NMIBC的另一种传统方法。尽管如此,这些当前的治疗措施在控制NMIBC方面疗效有限,并且不能提供全面的长期缓解。因此,生物材料和支架似乎是一种有效的介质,可用于递送治疗剂以在治疗后重塑膀胱。干细胞和富血小板血浆等再生疗法也已被探索用于解决NMIBC的可能方案。基于上述方法,我们全面分析了从传统干预到再生干预治疗NMIBC的治疗历程。