概述,诊断,和手术期间的系统治疗上通道尿路癌的尿路癌
Adam Kolawa1, Anishka D'Souza2, Varsha Tulpule2
1IRD 620, Department of Internal Medicine, University of Southern California, 2020 Zonal Avenue, Los Angeles, CA 90033, USA.
Cancers
|October 14, 2023
概括
上道泌尿道癌 (UTUC) 是具有侵略性的. 在临床试验中,外科化疗和免疫疗法显示出前景,一些研究表明,高风险的UTUC患者的治疗结果有所改善.
科学领域:
- 尿瘤学 尿瘤学
- 医学瘤学 医学瘤学
- 腎臟病學 (nephrology) 是一種醫學.
背景情况:
- 上道泌尿道癌 (UTUC) 是尿道癌的一小部分,但具有侵略性.
- 患者经常出现晚期疾病,需要有效的治疗策略,超出标准的激进瘤切除术.
- 从膀癌数据中推断出的术后治疗疗法的疗效正在UTUC的积极调查中.
研究的目的:
- 审查当前的外科手术前化学疗法和免疫疗法对上道泌尿道癌的现状.
- 总结研究新辅助和辅助治疗方式的关键临床试验的发现.
- 突出不断变化的治疗模式和需要在UTUC进行进一步的前性研究.
主要方法:
- 审查现有的文献和临床试验数据关于UTUC的术后治疗.
- 对回顾性研究和随机对照试验的分析 (例如,POUT,PURE-02,CheckMate-274).
- 检查各种新辅助和辅助疗法的治疗反应,生存益处和安全概况.
主要成果:
- 新辅助化疗在UTUC队列中显示了48%的病理客观反应率.
- 辅助化疗 (例如,以为基础的) 在POUT试验中显示出无疾病生存优势.
- 术后免疫疗法和化疗免疫疗法试验 (例如,伊皮利马布/尼沃马布,布罗利祖马布) 显示出不同但有时有希望的结果,包括病理完整反应和降级.
结论:
- 术后化疗和免疫疗法正在成为选择高风险UTUC患者的有价值选择.
- 虽然还不是标准的护理,但这些方法在未来的试验中需要进一步调查.
- 随着外科手术期间治疗的不断扩大,有可能改善侵入性泌尿腺癌的治疗结果.
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