[转移性尿路细胞癌的顺序治疗策略的当前景观]
Nozomi Hayakawa1, Eiji Kikuchi
1Dept. of Urology, St. Marianna University School of Medicine.
Gan to kagaku ryoho. Cancer & chemotherapy
|January 19, 2026
概括
对于转移性尿路细胞癌 (mUC) 的新一线治疗方法,恩福图马布维多丁加上庞布罗利祖马布 (EV+P) 和尼沃卢马布加上格姆西塔/西斯普拉丁 (Nivo+GC),提供了改进的选择. 维护治疗仍然是日本的标准,由现实世界的数据支持.
科学领域:
- 尿瘤学 尿瘤学
- 医学瘤学 医学瘤学
- 临床指南 临床指南
背景情况:
- 转移性尿路细胞癌 (mUC) 治疗已经发展,在2024年获得批准的新一线治疗方法.
- 恩福图马布维多丁加上潘布罗利祖马布 (EV+P) 显示出高效,EAU和NCCN指南推使用.
- 自2021年以来在日本的标准维护疗法Avelumab,有广泛的实践证据证明其有效性和安全性.
研究的目的:
- 审查目前对mUC的第一线治疗策略.
- 为了比较基于ICI的新组合与已建立的顺序疗法的证据基础.
- 以有效性,安全性和现实世界的数据为基础,为个性化治疗选择提供信息.
主要方法:
- 审查最近的临床试验数据和指南更新 (EAU,NCCN,JUA).
- 对日本的阿维卢马布维持疗法的现实世界证据的分析.
- 在没有头对头试验的情况下,对治疗选择的比较评估.
主要成果:
- 建议EV+P和Nivo+GC作为mUC的第一线疗法.
- 在日本,AVELUMAB的维持治疗是1级,A级的建议.
- 对于mUC,ICI组合和顺序疗法之间没有直接的比较试验.
结论:
- 最佳的mUC治疗选择需要仔细考虑疗效,安全性和现有的现实数据.
- 由于缺乏用于基化疗或阿维卢马布维护的预测生物标志物,因此需要个性化方法.
- 需要进一步的研究,直接比较新的组合与已建立的顺序治疗模式.
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