Bladder cancer is the 10th most popular cancer in the world, and non-muscle-invasive bladder cancer (NMIBC) is diagnosed in ~80% of all cases. Treatments for NMIBC include transurethral resection of the bladder tumor (TURBT) and intravesical instillations of Bacillus Calmette-Guérin (BCG). Treatment of BCG-unresponsive tumors is scarce and usually leads to Radical Cystectomy. In this paper, we review recent advancements in conservative treatment of BCG-unresponsive tumors. The main focus of the paper is FDA-approved medications: Pembrolizumab and Nadofaragene Firadenovec (Adstiladrin). Other, less researched therapeutic possibilities are also included, namely: N-803 immunotherapy, TAR-200 and TAR-210 intravesical delivery systems and combined Cabazitaxel, Gemcitabine and Cisplatin chemotherapy. Conservative treatment and delaying radical cystectomy would greatly benefit patients’ quality of life; it is undoubtedly the future of BCG-unresponsive NMIBC.
膀胱癌是全球第十大常见癌症，其中约80%的病例被诊断为非肌层浸润性膀胱癌（NMIBC）。NMIBC的治疗手段包括经尿道膀胱肿瘤切除术（TURBT）和卡介苗（BCG）膀胱灌注疗法。针对BCG治疗无效型肿瘤的保守治疗方案较为有限，通常最终需行根治性膀胱切除术。本文综述了BCG治疗无效型肿瘤保守治疗的最新进展，重点聚焦于美国食品药品监督管理局批准的两种药物：帕博利珠单抗与纳德拉法基因菲拉多韦（商品名Adstiladrin）。同时探讨了其他尚处研究阶段的治疗可能性，包括：N-803免疫疗法、TAR-200与TAR-210膀胱灌注给药系统，以及卡巴他赛联合吉西他滨与顺铂的化疗方案。保守治疗及延迟根治性膀胱切除术将显著提升患者生活质量，这无疑是BCG治疗无效型NMIBC未来发展的必然方向。
肿瘤(癌症)患者之家