Non-muscle-invasive bladder cancer: An overview of potential new treatment options
Neal D Shore1, Joan Palou Redorta2, Gregoire Robert3
1Carolina Urologic Research Center, Myrtle Beach, SC, USA.
Aim:
This review article summarizes the current clinical practice guidelines around disease definitions and risk stratifications, and the treatment of non-muscle-invasive bladder cancer (NMIBC). Recently completed and ongoing clinical trials of novel and investigational therapies in Bacillus Calmette-Guérin (BCG)-naïve, BCG-recurrent, and BCG-unresponsive patient populations are also described, e.g., those involving immune checkpoint inhibitors, targeted therapies, other chemotherapy regimens, vaccines, and viral- or bacterial-based treatments. Finally, a brief overview of enhanced cystoscopy and drug delivery systems for the diagnosis and treatment of NMIBC is provided.
Background:
A global shortage of access to BCG is affecting the management of BCG-naïve and BCG-recurrent/unresponsive NMIBC; hence, there is an urgent need to assist patients and urologists to enhance the treatment of this disease.
Methods:
Searches of ClinicalTrials.gov, PubMed, and Google Scholar were conducted. Published guidance and conference proceedings from major congresses were reviewed.
Conclusion:
Treatment strategies for NMIBC are generally consistent across guidelines. Several novel therapies have demonstrated promising antitumor activity in clinical trials, including in high-risk or BCG-unresponsive disease. The detection, diagnosis, surveillance, and treatment of NMIBC have also been improved through enhanced disease detection.
Insights
This review covers non-muscle-invasive bladder cancer (NMIBC) guidelines and novel therapies. Emerging treatments show promise for BCG-naïve, recurrent, and unresponsive cases, addressing current BCG shortages.
Area of Science:
- Urology
- Oncology
Background:
- A global shortage of Bacillus Calmette-Guérin (BCG) impacts non-muscle-invasive bladder cancer (NMIBC) management.
- There is an urgent need for enhanced treatment strategies for NMIBC patients, particularly those who are BCG-naïve or have recurrent/unresponsive disease.
Purpose of the Study:
- To review current clinical practice guidelines for NMIBC disease definitions, risk stratification, and treatment.
- To summarize novel and investigational therapies for NMIBC in BCG-naïve, BCG-recurrent, and BCG-unresponsive patient populations.
- To provide an overview of enhanced diagnostic and therapeutic systems for NMIBC.
Main Methods:
- Systematic literature search of ClinicalTrials.gov, PubMed, and Google Scholar.
- Review of published clinical practice guidelines and major congress proceedings.
Main Results:
- NMIBC treatment strategies are largely consistent across existing guidelines.
- Novel therapies demonstrate promising antitumor activity in clinical trials, including for high-risk or BCG-unresponsive NMIBC.
- Enhanced cystoscopy and drug delivery systems are improving NMIBC detection, diagnosis, surveillance, and treatment.
Conclusions:
- Current guidelines offer consistent NMIBC treatment approaches.
- Emerging therapies show significant potential for managing challenging NMIBC cases.
- Advancements in diagnostic and treatment technologies enhance the care of NMIBC patients.
Related Concept Videos
02:56Treatment Resistant Cancers
02:57Targeted Cancer Therapies
There are several types of targeted therapies against...