Advanced bladder cancer patients have historically failed to achieve prolonged duration of response to conventional chemotherapy and needed better first-line treatment regimens. The approval of nivolumab in combination with gemcitabine and cisplatin and pembrolizumab with antibody–drug conjugate enfortumab vedotin has revolutionized the first-line treatment of advanced bladder cancer in many countries. In this review, we summarize the intricate differences between the two landmark clinical trials that led to their incorporation into the current standard of care for advanced bladder cancer. We further discuss newer novel treatment options in the second and subsequent lines of treatment on progression, like immunotherapy in combination with other agents, including fibroblast growth factors receptor inhibitors, human epidermal growth factor inhibitors, antibody–drug conjugates, tyrosine kinase inhibitors, and novel antibodies. Finally, we discuss the integration of these novel therapies into current clinical practice amidst the rapidly evolving landscape of advanced bladder cancer treatment, aiming to enhance patient outcomes.
晚期膀胱癌患者历来难以通过传统化疗获得持久的疗效反应，因此亟需更优的一线治疗方案。纳武利尤单抗联合吉西他滨与顺铂方案，以及帕博利珠单抗联合抗体偶联药物enfortumab vedotin的获批，已在多国彻底改变了晚期膀胱癌的一线治疗格局。本文综述了推动这两项方案纳入当前晚期膀胱癌标准治疗的两项里程碑临床试验之间的复杂差异，并进一步探讨了疾病进展后二线及后续治疗中的新型治疗方案，例如免疫疗法联合其他药物的策略，包括成纤维细胞生长因子受体抑制剂、人表皮生长因子抑制剂、抗体偶联药物、酪氨酸激酶抑制剂及新型抗体药物。最后，在晚期膀胱癌治疗格局快速演变的背景下，我们讨论了如何将这些新型疗法整合到当前临床实践中，以期改善患者预后。
肿瘤(癌症)患者之家