Current and Emerging Strategies in Bladder Cancer
Current and Emerging Strategies in Bladder Cancer
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DOI：
10.2174/187152012800617768
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发表时间：
2012-07-01
影响因子：
2.8
通讯作者：
Di Pierro, Giovanni Battista
中科院分区：
文献类型：
--
作者：
Carradori, Simone;Cristini, Cristiano;Di Pierro, Giovanni Battista
尿路上皮细胞癌是泌尿道最常见的恶性肿瘤之一。标准治疗、膀胱内化疗和免疫疗法虽然有效，但伴随着相当大的副作用，大约 30% 的患者要么对治疗没有反应，要么在 5 年内疾病复发。在肌肉浸润性尿路上皮癌的情况下，新辅助化疗的使用与总体生存获益相关。肌层浸润性膀胱癌危及生命，表现出适度的化学敏感性，通常需要根治性膀胱切除术。尽管膀胱癌具有相当好的遗传特征，但与其他实体瘤相比，分子靶向药物的临床试验数量很少，而且大多不成功。因此，膀胱癌对替代疗法来说是一个巨大的机遇和挑战。在这篇综述中，我们将重点关注有前途的全局或基于途径的方法（表观遗传调节剂、激酶抑制剂、血管生成阻断、过氧化物酶体增殖物激活受体激动剂、细胞凋亡诱导剂、病毒治疗），这些方法由对尿路上皮癌分子生物学的更深入了解支持，最近已在临床试验中进行了测试。
Urothelial cell carcinoma is one of the most common malignancies of the urinary tract. The standard of care, intravesical chemo- and immunotherapy, while effective, is associated with a considerable side-effect profile and approximately 30% of patients either fail to respond to treatment or suffer recurrent disease within 5 years. In the setting of muscle-invasive urothelial carcinoma, use of neoadjuvant chemotherapy is associated with overall survival benefit. Muscle invasive bladder cancer is life threatening, showing modest chemosensitivity, and usually requires radical cystectomy. Although bladder cancer is fairly well-genetically characterized, clinical trials with molecularly targeted agents have, in comparison to other solid tumors, been few in number and largely unsuccessful. Hence, bladder cancer represents a considerable opportunity and challenge for alternative therapies. In this review, we will focus on promising global or pathway-based approaches (epigenetic modulators, kinase inhibitors, angiogenesis blockage, peroxisome proliferator-activated receptor. agonists, apoptosis inductors, virus therapy) supported by a deeper understanding of molecular biology of urothelial carcinoma, which have been recently tested in clinical trials.