围手术期免疫检查点抑制剂在肌肉浸润性膀胱癌中的作用。

IF 3.2 Q2 ONCOLOGY Oncology and Therapy Pub Date : 2023-03-01 Epub Date: 2023-01-03 DOI:10.1007/s40487-022-00218-z

Saachi Chhaya, Isabella Watts, Kenrick Ng, Rami Mustapha, Thomas Powles, Anand Sharma, Nikhil Vasdev

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引用次数: 3

摘要

目的:我们的目的是描述和强调免疫检查点抑制剂(ICIs)目前在肌肉浸润性膀胱癌(MIBC)治疗领域的应用，特别是在围手术期的应用。我们提供了在围手术期使用ICI的关键试验的综合综述，讨论了试验结果和局限性，并回顾了生物标志物的作用。导读:ICIs最近被纳入转移性尿路上皮癌的治疗方案。30多篇已发表的研究调查了这些药物在MIBC根治性治疗中的作用。一些研究显示了相互矛盾的结果，影响了在临床实践中的广泛采用。方法:我们对PubMed、MEDLINE、Embase、欧洲肿瘤医学学会/美国临床肿瘤学会年会论文集和clinicaltrials.gov数据库中截至2021年12月的文献进行了叙述性综述。讨论:我们描述了新辅助治疗和辅助治疗的关键试验结果，研究结果相互矛盾的一些原因，以及对临床实践的影响。讨论了该领域的相关生物标志物，并简要概述了膀胱癌的免疫微环境。结论:围手术期ICIs在新辅助治疗中表现出良好的疗效和低毒性。这两项关于佐剂的大型试验是相互矛盾的。与化疗相比，围手术期ICIs的疗效、良好的耐受性和更好的毒性特征，以及生物标志物驱动的患者选择的潜力，可能会导致未来实践的改变。然而，对于那些接受ICIs治疗的患者，缺乏长期生存和毒性数据，这需要进一步发展，以证明使用ICIs有额外的生存益处。

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Role of Perioperative Immune Checkpoint Inhibitors in Muscle Invasive Bladder Cancer.

Objective: We aim to describe and highlight the current use of immune checkpoint inhibitors (ICIs) in the muscle invasive bladder cancer (MIBC) treatment landscape, particularly focusing on the perioperative setting. We provide a comprehensive review of key trials of the use of ICI in the perioperative setting, discussing trial outcomes and limitations and reviewing the role of biomarkers.

Introduction: ICIs have recently been integrated into the treatment algorithm for metastatic urothelial carcinoma. More than 30 published studies have investigated the role of these agents in the radical treatment of MIBC. Some studies have demonstrated conflicting results, affecting widespread adoption in clinical practice.

Methods: We performed a narrative overview of the literature from databases including PubMed, MEDLINE, Embase, European society of Medical Oncology/American Society of Clinical Oncology Annual Proceedings, and clinicaltrials.gov databases up until December 2021.

Discussion: We described the results of key trials in the neoadjuvant and adjuvant setting, some of the reasons for conflicting study results, and the implications for clinical practice. Relevant biomarkers in the field are discussed, alongside a brief overview of the immune microenvironment in bladder cancer.

Conclusions: Perioperative ICIs have shown promising efficacy with low toxicity in the neoadjuvant setting. The two large trials in the adjuvant setting have been contradictory. The efficacy of perioperative ICIs combined with favorable tolerability and better toxicity profile compared with chemotherapy, with the potential for biomarker-driven patient selection, may lead to a change in future practice. There is, however, a lack of long-term survival and toxicity data for those treated with ICIs, and this needs to be developed further to demonstrate an added survival benefit by using ICIs.

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来源期刊

Oncology and Therapy ONCOLOGY-

CiteScore

3.40

自引率

0.00%

发文量

审稿时长

6 weeks

期刊介绍： Now indexed in PubMed Aims and Scope Oncology and Therapy is an international, peer reviewed, rapid-publication (peer review in 2 weeks, published 3–4 weeks from acceptance) journal dedicated to the publication of high-quality pre-clinical, clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of therapeutics and interventions (including devices) across all therapeutic areas. Studies relating to diagnostics and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged. The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Oncology and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. 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