New Intravesical Agents for BCG-Unresponsive High-Risk Non-Muscle Invasive Bladder Cancer
Asimakopoulos, Anastasios D. (Fondazione PTV Policlinico Tor Vergata)
Kochergin, Maxim (BG Unfallkrankenhaus Berlin)
Colalillo, Gaia (Fondazione PTV Policlinico Tor Vergata)
Fahmy, Omar (Universiti Putra Malaysia (UPM))
Hassan, Fahmy (King Salman Hospital (MOH))
Renninger, Markus (Eberhard-Karls University Tuebingen)
Gallioli, Andrea (Institut d'Investigació Biomèdica Sant Pau)
Gavrilov, Pavel (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Gakis, Georgios (Martin-Luther-University Halle-Wittenberg)
Universitat Autònoma de Barcelona

Data:	2023
Resum:	With the exception of the FDA-approved valrubicin and pembrolizumab, there are no standard second-line treaments for BCG-unresponsive high-risk non-muscle invasive bladder cancer (NMIBC). To provide a systematic review of the novel intravesically administered therapeutic agents for the salvage treatment of BCG-unresponsive NMIBC. Online search of the PubMed, EMBASE and Web of Science databases was performed. The endpoints of this review were to evaluate the efficacy of the agents in terms of complete response rates (CR) and durability of CR, overall survival, recurrence-free survival and cancer-specific survival and to report on their toxicity profile. A search on Clinicaltrials. gov was performed to identify ongoing clinical trials. 14 studies were included in this review. The critical clinical need for the development of an effective, safe and durable intravesical drug for the salvage treatment of high-risk NMIBC seems to be met mainly by intravesical gene therapy; in fact, data support the FDA-approved nadofaragene firadenovec as a potentially important therapeutic advancement in this context. Promising results are also being obtained by the combination of N-803/BCG and by innovative drug delivery systems. Considering the plethora of novel intravesical treatments that have completed phase II evaluation, one can reasonably expect that clinicians will soon have at their disposal new agents and treatment options for BCG-unresponsive NMIBC. In the near future, it will be up to the urologist to identify, for each specific patient, the right agent to use, based on safety, results and cost-effectiveness.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Llengua:	Anglès
Document:	Article de revisió ; recerca ; Versió publicada
Matèria:	BCG ; Bladder cancer ; Bladder instillations ; Intravesical instillations ; Non-muscle invasive bladder cancer
Publicat a:	Bladder Cancer, Vol. 9 Núm. 3 (25 2023) , p. 237-251, ISSN 2352-3735

DOI: 10.3233/BLC-230043
PMID: 38993180

15 p, 322.3 KB

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