Journal article
The current landscape of salvage therapies for patients with bacillus Calmette-Guerin unresponsive nonmuscle invasive bladder cancer
Current opinion in urology, Vol.31(3), pp.178-187
05/01/2021
DOI: 10.1097/MOU.0000000000000863
PMID: 33742981
Abstract
Purpose of review Although radical cystectomy represents the gold standard treatment for patients with high-risk nonmuscle invasive bladder cancer (NMIBC) whose disease does not respond to bacillus Calmette-Guerin (BCG), many patients are unable or unwilling to undergo surgery. The need remains for effective bladder-preserving therapies. This review aims to describe existing treatments, contemporary research in this field and ongoing trials of salvage therapies for patients with BCG-unresponsive NMIBC. Recent findings Intravesical chemotherapy has been utilized frequently in this setting. Emerging data on combination regimens such as intravesical gemcitabine and docetaxel and intravesical cabazitaxel, gemcitabine and cisplatin are promising; nevertheless, larger, prospective trials are needed. Meanwhile, the intravenous checkpoint inhibitor pembrolizumab was recently FDA-approved for patients BCG-unresponsive NMIBC. Encouraging clinical trial results for intravesical nadofaragene firadenovec, oportuzumab monatox and ALT-803 + BCG have been released, while data from trials of other treatment strategies, including novel chemotherapy and drug delivery, augmented BCG immunotherapy, adenoviral and gene therapy, targeted therapy, and combination systemic immunotherapy with intravesical agents, are eagerly awaited. Several novel salvage therapies offer promise for patients with BCG-unresponsive NMIBC. Patient selection, efficacy, safety, cost and ease of administration must be carefully considered to determine the optimal treatment approach.
Details
- Title: Subtitle
- The current landscape of salvage therapies for patients with bacillus Calmette-Guerin unresponsive nonmuscle invasive bladder cancer
- Creators
- Vignesh T. Packiam - University of IowaJordan Richards - University of IowaMaximilian Schmautz - University of CologneAxel Heidenreich - University of CologneStephen A. Boorjian - Mayo Clinic in Arizona
- Resource Type
- Journal article
- Publication Details
- Current opinion in urology, Vol.31(3), pp.178-187
- Publisher
- Lippincott Williams & Wilkins
- DOI
- 10.1097/MOU.0000000000000863
- PMID
- 33742981
- ISSN
- 0963-0643
- eISSN
- 1473-6586
- Number of pages
- 10
- Language
- English
- Date published
- 05/01/2021
- Academic Unit
- Urology
- Record Identifier
- 9984319973302771
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