对于BCG不响应的高风险非肌肉侵入性膀癌的新型免疫治疗选择
Zein Alabdin Hannouneh1,2, Amjad Hijazi1,2, Alaa Aldeen Alsaleem1,2
1Faculty of Medicine, Al Andalus University for Medical Sciences, Tartus, Syrian Arab Republic.
Cancer medicine
|December 1, 2023
概括
具有高风险的非肌肉侵入性膀癌 (HR-NMIBC) 抵抗BCG疗法提出了挑战. 新的免疫疗法正在探索,但长期的膀保护仍然是一个未满足的需求.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
背景情况:
- 高风险的非肌肉侵入性膀癌 (HR-NMIBC) 由于对Bacillus Calmette-Guérin (BCG) 治疗的耐药性而具有挑战性.
- 不响应BCG的NMIBC可以发展为肌肉侵入性膀癌 (MIBC),往往需要进行激进囊切除术 (RC) 并影响生活质量.
- 全球BCG短缺进一步使管理复杂化,突出了需要替代性膀保护策略的需要.
研究的目的:
- 审查目前和新兴的BCG不响应HR-NMIBC的治疗方法.
- 为了确定这个患者群体的膀保护疗法的未满足需求.
主要方法:
- 在PubMed (2019-2023) 的文献中搜索HR-NMIBC治疗方法.
- 包括来自ClinicalTrials.gov.gov的免疫相关药物的临床试验.
主要成果:
- 探索性治疗包括免疫检查点抑制剂 (ICI),性病毒疗法和各种免疫调节剂.
- 组合疗法表现出协同效应,并且比单一疗法更受欢迎.
- 布罗利祖马布,瓦尔鲁比辛和纳多法拉基因firadenovec-vncg被FDA批准用于BCG不响应的NMIBC,但往往会延迟而不是取代RC.
结论:
- 在BCG不响应的HR-NMIBC中,对于有效的膀保护疗法存在重大未满足的需求.
- 对组合策略,生物标志物和试验设计的进一步研究对于开发新疗法至关重要.
- 增强免疫疗法需要更深入地了解BCG耐药机制和进展途径.
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