Mao Jiaquan, Yang Chunguang, Xin Sheng, Cui Kai, Liu Zheng, Wang Tao, Hu Zhiquan, Wang Shaogang, Liu Jihong, Song Xiaodong, Song Wen
Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Front Med (Lausanne). 2022 Aug 1;9:949567. doi: 10.3389/fmed.2022.949567. eCollection 2022.
Cisplatin-based neoadjuvant chemotherapy combined with radical cystectomy (RC) plus pelvic lymph node dissection (PLND) is the preferred treatment option for muscle-invasive bladder cancer (MIBC). However, some patients are unable to tolerate RC or may have postoperative complications after RC. And most patients have a strong desire for bladder-preserving treatment. There are no reports on the efficacy of maximal transurethral resection of the bladder tumor (TURBT) in combination with chemotherapy plus tislelizumab for bladder-preserving in recurrent MIBC patients.
We report two cases diagnosed with recurrent MIBC who achieved pathological complete response (pCR) and bladder-preserving after maximal TURBT combined with chemotherapy plus tislelizumab.
Postoperative immunotherapy should be considered for all patients with recurrent MIBC who are eligible for immunotherapy. In addition, high programmed death ligand-1 (PD-L1) expression, high tumor mutation burden (TMB), and mutation level can be combined to predict tislelizumab efficacy.
基于顺铂的新辅助化疗联合根治性膀胱切除术（RC）加盆腔淋巴结清扫术（PLND）是肌层浸润性膀胱癌（MIBC）的首选治疗方案。然而，一些患者无法耐受RC，或者RC术后可能出现并发症。而且大多数患者强烈希望保留膀胱。对于复发性MIBC患者，最大经尿道膀胱肿瘤切除术（TURBT）联合化疗加替雷利珠单抗进行膀胱保留治疗的疗效尚无报道。
我们报告了2例诊断为复发性MIBC的患者，他们在接受最大TURBT联合化疗加替雷利珠单抗治疗后实现了病理完全缓解（pCR）并保留了膀胱。
所有符合免疫治疗条件的复发性MIBC患者均应考虑术后免疫治疗。此外，高程序性死亡配体-1（PD-L1）表达、高肿瘤突变负荷（TMB）和突变水平可联合起来预测替雷利珠单抗的疗效。
