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Immunotherapy in non-muscle-invasive bladder cancer: current status and future directions.

Authors
  • Pfail, John L1
  • Katims, Andrew B1
  • Alerasool, Parissa2
  • Sfakianos, John P3
  • 1 Department of Urology, Icahn School of Medicine at Mount Sinai Hospital, 1425 Madison Avenue, 6th Floor, New York City, NY, 10029, USA.
  • 2 School of Medicine, New York Medical College, Valhalla, NY, USA.
  • 3 Department of Urology, Icahn School of Medicine at Mount Sinai Hospital, 1425 Madison Avenue, 6th Floor, New York City, NY, 10029, USA. [email protected]
Type
Published Article
Journal
World journal of urology
Publication Date
Oct 15, 2020
Identifiers
DOI: 10.1007/s00345-020-03474-8
PMID: 33057888
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Patients harboring high-grade non-muscle-invasive bladder cancer (NMIBC) experience high rates of both recurrence and progression. Currently, few treatment options besides cystectomy exist for this at-risk population, especially those with BCG-unresponsive disease. The purpose of this review is to present the current status and describe future directions of immunotherapy in NMIBC. The PubMed and Google Scholar databases were searched for articles pertaining to immunotherapy in NMIBC. Relevant planned and ongoing clinical trials were identified using www.ClinicalTrials.gov . Published randomized control trials, reviews, other retrospective and prospective studies deemed relevant were used in this review paper. Novel immunotherapies used in the treatment of high-grade NMIBC and BCG-unresponsive disease allow patients more options and have the potential to reduce the need for radical cystectomy. Currently, several options target the programmed death 1 (PD-1)/programmed death ligand 1 (PD-L1) axis as this mechanism of immunotherapy has been shown to be effective in several cancers, including bladder, melanoma, and lung cancers. In addition, other immunotherapy options for the treatment of NMIBC include viral gene therapies, interleukin-15 superagonists, small molecule inhibitors of indoleamine (2,3)-dioxygenase 1, and vaccines. The current landscape of immunotherapy in bladder cancer is rapidly evolving, with much literature pertaining to muscle-invasive and metastatic disease. However, the implementation of these treatment options in high-grade NMIBC may allow patients to avoid life-altering surgery. Reliable biomarkers for response are needed to further select patients who may benefit from such therapies.

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