Novel intravesical therapies and delivery systems for the management of bladder cancer.

IF 2.1 3区医学 Q2 UROLOGY & NEPHROLOGY Current Opinion in Urology Pub Date : 2025-01-01 Epub Date: 2024-10-07 DOI:10.1097/MOU.0000000000001232

Elisabeth Grobet-Jeandin, Morgan Rouprêt, Thomas Seisen

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Abstract

Purpose of review: Bladder cancer is a substantial burden for public health worldwide. A risk-adapted treatment strategy is required for non muscle-invasive (NMIBC) and muscle-invasive bladder cancer (MIBC). To date, treatment includes surgery with or without peri-operative local or systemic treatment. The aim of this review was to explore novel intravesical therapies and delivery systems emerging in NMIBC and MIBC.

Recent findings: Several novel intravesical therapies and delivery systems for NMIBC and MIBC treatment recently emerged. Hyperthermic intravesical chemotherapy (HIVEC) allows a reasonable cancer control in selected high-risk NMIBC. Novel intravesical drugs such as nadofaragene firadenovec, Oncofid-P-B or Nogapendekin alfa-inbakicept seem to be safe and well tolerated. However, their efficacy in high-risk NMIBC should be further investigated. Hydrogels appear to be safe, well tolerated and potentially efficient in primary chemoablation in selected cases of low-grade intermediate-risk NMIBC tumors. Drug-releasing intravesical systems (drug-RIS) such as TAR-200 are safe and well tolerated, providing high partial and complete response rate in both NMIBC and MIBC patients.

Summary: The armamentarium for the treatment of bladder cancer patients is expanding, notably with HIVEC, hydrogels, drug-RIS and novel therapies. However, accurate patients' selection is key to prevent disease progression in any bladder-sparing strategy, and radical cystectomy remains the gold-standard to date.

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用于治疗膀胱癌的新型膀胱内疗法和给药系统。

审查目的：膀胱癌是全球公共卫生的沉重负担。对于非肌层浸润性膀胱癌（NMIBC）和肌层浸润性膀胱癌（MIBC），需要一种适应风险的治疗策略。迄今为止，治疗方法包括手术和围手术期局部或全身治疗。本综述旨在探讨治疗非肌层浸润性膀胱癌和肌层浸润性膀胱癌的新型膀胱内疗法和给药系统：最近出现了几种用于治疗 NMIBC 和 MIBC 的新型膀胱内疗法和给药系统。高热膀胱内化疗（Hyperthermic intravesical chemotherapy，HIVEC）可使选定的高危 NMIBC 得到合理的癌症控制。新型膀胱内药物，如 nadofaragene firadenovec、Oncofid-P-B 或 Nogapendekin alfa-inbakicept 似乎安全且耐受性良好。不过，它们对高风险 NMIBC 的疗效还需进一步研究。水凝胶似乎安全、耐受性良好，而且可能有效地用于低级别中度风险 NMIBC 肿瘤特定病例的初次化疗消融。TAR-200等膀胱内药物释放系统（drug-RIS）安全且耐受性良好，可为NMIBC和MIBC患者提供较高的部分和完全反应率。摘要：治疗膀胱癌患者的手段正在不断增多，尤其是HIVEC、水凝胶、drug-RIS和新型疗法。然而，在任何保膀胱策略中，准确选择患者是防止疾病进展的关键，而根治性膀胱切除术至今仍是黄金标准。

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来源期刊

Current Opinion in Urology 医学-泌尿学与肾脏学

CiteScore

5.00

自引率

4.00%

发文量

140

审稿时长

6-12 weeks

期刊介绍： Current Opinion in Urology delivers a broad-based perspective on the most recent and most exciting developments in urology from across the world. Published bimonthly and featuring ten key topics – including focuses on prostate cancer, bladder cancer and minimally invasive urology – the journal’s renowned team of guest editors ensure a balanced, expert assessment of the recently published literature in each respective field with insightful editorials and on-the-mark invited reviews.