Systemic therapy for metastatic bladder cancer in 2016 and beyond.
Systemic therapy for metastatic bladder cancer in 2016 and beyond.
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DOI：
10.2217/fon-2015-0020
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发表时间：
2016-02
期刊：
影响因子：
3.3
通讯作者：
A. Collazo-Lorduy;M. Galsky
中科院分区：
文献类型：
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作者：
A. Collazo-Lorduy;M. Galsky
转移性尿路上皮癌通常与不良预后有关。在一线治疗中，以铂为基础的化疗是治疗的标准，但耐药性迅速发展，绝大多数患者最终经历疾病进展。尽管几十年的临床药物开发专注于治疗对铂耐药的转移性尿路上皮癌，但截至2015年底，美国FDA还没有批准这种标准疗法。然而，最近一系列探索创新方法的试验的初步结果预测，这种难以治疗的恶性肿瘤的管理将发生“翻天覆地的变化”。在此，我们综述了治疗转移性尿路上皮癌患者的新方法，主要集中在三个关键的治疗靶区：复发的躯体改变、肿瘤新生血管和肿瘤相关的免疫逃逸。
Metastatic urothelial cancer is generally associated with poor outcomes. In the first-line setting, platinum-based chemotherapy is the standard of care but resistance rapidly develops and the vast majority of patients ultimately experience disease progression. Despite several decades of clinical drug development focused on the treatment of platinum-resistant metastatic urothelial cancer, as of late 2015 there are no standard therapies approved by the US FDA in this setting. However, preliminary results from a series of recent trials exploring innovative approaches forecast a 'sea change' in the management of this difficult to treat malignancy. Herein, we review new approaches for the management of patients with metastatic urothelial cancer focused on three key therapeutic target areas: recurrent somatic alterations, the tumor neovasculature and tumor-associated immune escape.