The landscape of treatment for non-muscle invasive bladder cancer is rapidly changing. A complete and careful transurethral resection is the mainstay of initial treatment and is followed by intravesical therapy in intermediate or high-risk cases. The standard of care is intravesical BCG. Many alternative or additive approaches to this are being explored. We divided this review into three relevant spaces to consider these novel treatment approaches: (1) low-risk disease, for which intravesical therapy is not usually considered, (2) BCG-naïve disease (i.e., considering alternatives to the standard therapy), and (3) BCG-unresponsive disease. We performed a review of published literature and summarized ongoing trials in the United States. Novel approaches that we explored include surgical techniques for resection, alterations in dwell time for intravesical therapy, delivery method and schedule of intravesical therapies, new intravesical therapy agents, and systemic therapies (especially immunotherapy). These are thoroughly outlined throughout this review article, and the numerous modalities being studied demonstrate significant promise for the future treatment of the expanding space of NMIBC.
非肌层浸润性膀胱癌的治疗格局正在迅速变化。完整细致的经尿道膀胱肿瘤切除术是初始治疗的主要手段，中危或高危病例术后需辅以膀胱灌注治疗。目前标准治疗方案为卡介苗膀胱灌注。针对该疗法的多种替代或补充方案正在探索中。本综述将新型治疗方法划分为三个相关领域进行探讨：（1）通常不考虑膀胱灌注治疗的低危疾病；（2）未接受过卡介苗治疗的患者（即考虑标准疗法的替代方案）；（3）对卡介苗治疗无应答的患者。我们系统回顾了已发表文献并总结了美国正在进行的临床试验。探讨的新型方法包括：肿瘤切除手术技术、膀胱灌注药物留置时间的调整、膀胱灌注给药方式与疗程方案、新型膀胱灌注药物以及全身性治疗（特别是免疫疗法）。本文对这些内容进行了全面阐述，众多正在研究的新型治疗模式为不断扩展的非肌层浸润性膀胱癌治疗领域展现了广阔前景。
Treatment Modalities for Non-Muscle Invasive Bladder Cancer: An Updated Review
肿瘤(癌症)患者之家