肌肉侵入性膀癌中的系统治疗决策算法:临床复杂性和导航以改善结果
Megan Giles1, Simon J Crabb1,2
1Department of Medical Oncology, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
Research and reports in urology
|July 13, 2023
概括
肌肉侵入性膀癌的预后不好,许多患者复发. 目前的治疗包括化疗和免疫疗法,但需要新的向疗法和生物标志物来获得更好的结果.
科学领域:
- 在瘤学瘤学.
- 医学研究 医学研究
背景情况:
- 肌肉侵入性膀癌 (MIBC) 是一个重大的临床挑战,复发率高,预后不佳,特别是在晚期.
- 目前的全身治疗,包括基于的化疗和PD-1/PD-L1免疫疗法,提供适度的生存益处.
研究的目的:
- 审查目前的肌肉侵入性膀癌的全身治疗选择,在息和治愈的环境中.
- 突出MIBC治疗的证据,局限性和新兴治疗目标.
主要方法:
- 对肌肉侵入性膀癌的全身治疗现有文献的综述.
- 分析有关化疗,免疫疗法,抗体-药物合物和新兴向疗法的数据.
- 评估生物标志物开发及其在MIBC中的挑战.
主要成果:
- 基于的化疗仍然是基石,基于的疗法在符合条件的患者中提供了适度的治愈率改善.
- 免疫疗法 (PD-1/PD-L1抑制剂) 在晚期疾病中显示出适度的存活率增长,最佳使用可能作为切换维护策略.
- 恩福图马布维多丁 (Enfortumab vedotin) 是以前接受治疗的患者的一种既定选择;新兴的点包括Trop-2,FGFR,HER2和DNA修复缺陷.
结论:
- 开发验证的预测生物标志物对于推进MIBC治疗策略至关重要.
- 虽然目前的疗法有所改善,但仍有大量未满足的需求,需要进一步研究新的治疗点和组合.
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