Ai K, Li Y
Department of Urology, the Second Xiangya Hospital of Central South University, Changsha 410011, China.
Zhonghua Wai Ke Za Zhi. 2021 Nov 1;59(11):881-885. doi: 10.3760/cma.j.cn112139-20210820-00382.
Urothelial carcinoma is the common malignancy involving the urinary system. Cisplatin-based chemotherapy is the initial regimen of choice for cisplatin-eligible patients with metastatic urothelial carcinoma. However, due to toxicity, the regimen is not well tolerated in part of the patients, such as in elderly patients or those with multiple complications, and there is still a risk of recurrence. During the past years, immune checkpoint inhibitors (ICI) have become available as a new option for urothelial carcinoma patients, with the benefits of clinical efficacy and quality of life. Development and researches of the ICI axis blockade have changed the contemporary treatment paradigm for patients with locally advanced or metastatic urothelial carcinoma. In addition, multiple clinical studies of combined treatment strategies of ICI have been explored recently. It is necessary to further understand the clinical value of ICI through summarizing the evidence supporting the use of checkpoint inhibitors for patients with inoperable locally advanced or metastatic urothelial carcinoma, which also may helpful to perspective the future research direction of combined strategies and precision medicine in urothelial carcinoma immunotherapy.
尿路上皮癌是泌尿系统常见的恶性肿瘤。以顺铂为基础的化疗是符合顺铂使用条件的转移性尿路上皮癌患者的首选初始治疗方案。然而，由于毒性，部分患者（如老年患者或有多种并发症的患者）对该方案耐受性不佳，且仍有复发风险。在过去几年中，免疫检查点抑制剂（ICI）已成为尿路上皮癌患者的一种新选择，具有临床疗效和生活质量方面的优势。ICI轴阻断的发展和研究改变了局部晚期或转移性尿路上皮癌患者的当代治疗模式。此外，最近还探索了ICI联合治疗策略的多项临床研究。有必要通过总结支持将检查点抑制剂用于无法手术的局部晚期或转移性尿路上皮癌患者的证据，进一步了解ICI的临床价值，这也可能有助于展望尿路上皮癌免疫治疗联合策略和精准医学的未来研究方向。
