Recent Advances in Drug Delivery Strategies for High-Risk BCG-Unresponsive Non-Muscle Invasive Bladder Cancer: A...

Area of Science:

• Urology
• Oncology
• Biomedical Engineering

Background:

• High-risk non-muscle invasive bladder cancer (NMIBC) often recurs after Bacillus Calmette-Guérin (BCG) treatment.
• A significant proportion of patients with BCG-unresponsive NMIBC eventually require radical cystectomy (RC).
• There is a critical unmet need for novel therapies to treat BCG-unresponsive NMIBC and prevent disease progression.

Purpose of the Study:

• To review current and emerging therapies for high-risk BCG-unresponsive NMIBC investigated in clinical trials.
• To provide an overview of drug delivery system designs for these novel therapies.
• To summarize clinical outcomes reported as of July 2024 to guide future treatment development.

Main Methods:

• Review of clinical trials and scientific literature on NMIBC therapies.
• Analysis of drug delivery strategies including targeted delivery, sustained release, and permeabilization.
• Synthesis of reported clinical outcomes for various therapeutic modalities.

Main Results:

• Three biologics (Keytruda, Adstiladrin, Anktiva) are FDA-approved for NMIBC.
• Gene therapies and other novel drug modalities show promise in clinical trials.
• Advances in drug delivery are essential for enhancing therapeutic efficacy in bladder cancer.

Conclusions:

• The field of NMIBC treatment is rapidly evolving with new therapeutic options.
• Optimized drug delivery systems are key to overcoming challenges in treating BCG-unresponsive NMIBC.
• This review provides insights for developing next-generation therapies and delivery systems for high-risk NMIBC.