Background/Objectives:To summarize the relevant trials relating to novel strategies and therapeutic advances in the treatment of bladder cancer.Methods:A comprehensive review of the literature and recent/ongoing clinical trials was conducted, focusing on novel treatments and strategies for bladder cancer. Trials started or published as of 2020 were included.Results:The standard of care for MIBC remains neoadjuvant chemotherapy with perioperative immunotherapy in the cisplatin-eligible population, while guidelines do not exist for cisplatin-ineligible patients. Strategies under investigation include combinations of chemotherapy, immunotherapy, radiation, and/or novel therapies, such as ADCs, targeted agents, intravesical treatments, and personalized vaccines. Bladder-sparing approaches using these novel therapies are also being studied. In the advanced/metastatic setting, enfortumab vedotin plus pembrolizumab has supplanted platinum-based chemotherapy as the first-line treatment option. For those with contraindications, or who progress, strategies under investigation include newer immunotherapies and ADCs, novel small molecule inhibitors, and cellular therapies.Conclusions:The treatment landscape for bladder cancer has changed drastically within the last few years. Ongoing trials hope to build on this success by investigating bladder-sparing strategies for MIBC and novel systemic therapies in advanced patients.
背景/目的：总结膀胱癌治疗新策略与治疗进展的相关临床试验。 方法：对文献及近期/正在进行的临床试验进行全面综述，重点关注膀胱癌的新型治疗方法和策略。纳入2020年启动或发表的试验。 结果：对于顺铂适用人群，肌层浸润性膀胱癌的标准治疗方案仍为新辅助化疗联合围手术期免疫治疗，而顺铂不适用患者尚无明确指南。正在研究的策略包括化疗、免疫治疗、放疗和/或新型疗法（如抗体药物偶联物、靶向药物、膀胱内治疗及个性化疫苗）的联合应用。基于这些新型疗法的保膀胱策略也在探索中。在晚期/转移性治疗领域，恩诺单抗联合帕博利珠单抗已取代铂类化疗成为一线治疗方案。对于存在禁忌症或病情进展的患者，研究策略包括新型免疫疗法与抗体药物偶联物、新型小分子抑制剂及细胞疗法。 结论：近年来膀胱癌的治疗格局已发生深刻变革。当前临床试验旨在以此为基础，进一步探索肌层浸润性膀胱癌的保膀胱策略及针对晚期患者的新型全身治疗方案。
Novel Strategies and Therapeutic Advances for Bladder Cancer
肿瘤(癌症)患者之家