The use of intravesical BCG in urothelial carcinoma of the bladder
The use of intravesical BCG in urothelial carcinoma of the bladder
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DOI：
10.3332/ecancer.2019.905
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发表时间：
2019-02-26
影响因子：
1.8
通讯作者：
Zlotta, Alexandre R.
中科院分区：
文献类型：
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作者：
Alhunaidi, Omar;Zlotta, Alexandre R.
非肌层浸润性膀胱癌（NMIBC）的高复发率和进展率促使研究人员研究膀胱内治疗的使用以预防它们。卡介苗（BCG）已经成功地用于该适应症以治疗NMIBC超过四十年，BCG是显示出降低NMIBC进展为肌肉浸润性疾病的风险的唯一膀胱内药剂。尽管临床应用已超过40年，但通常被认为是人类最成功的癌症免疫疗法的确切作用机制仍在很大程度上未知。不幸的是，BCG疗法并不是万能的，它仍然在高达40%的患者中失败。其中许多患者，尤其是高风险类别（T1高级别疾病、原位癌）的患者，将需要膀胱切除术等积极治疗，或者在某些情况下需要化疗和放疗等保留膀胱的治疗方案。事实上，BCG失败后的膀胱内治疗没有金标准。
The high recurrence and progression rates of non-muscle invasive bladder cancer (NMIBC) have led investigators to study the use of intravesical therapy in order to prevent them. Bacillus Calmette-Guerin (BCG) has been successfully used for this indication to treat NMIBC for more than four decades.BCG is the only intravesical agent shown to reduce the risk of progression of NMIBC to muscle-invasive disease. Despite over 40 years of clinical use, the precise mechanism of action for what has often been considered the most successful cancer immunotherapy in humans remains largely unknown.Unfortunately, BCG therapy is not a universal panacea and it still fails in up to 40% of patients. Many of these patients, especially in the high-risk category (T1 high-grade disease, carcinoma in situ) will require aggressive therapy like cystectomy or in selected cases bladder-sparing options like chemo-radiation. Indeed, there is no gold standard intravesical treatment after BCG failure.