Universität zu Köln

Packiam, Vignesh T., Richards, Jordan, Schmautz, Maximilian, Heidenreich, Axel and Boorjian, Stephen A. (2021). The current landscape of salvage therapies for patients with bacillus Calmette-Guerin unresponsive nonmuscle invasive bladder cancer. Curr. Opin. Urol., 31 (3). S. 178 - 188. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 1473-6586

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Abstract

Purpose of review Although radical cystectomy represents the gold standard treatment for patients with high-risk nonmuscle invasive bladder cancer (NMIBC) whose disease does not respond to bacillus Calmette-Guerin (BCG), many patients are unable or unwilling to undergo surgery. The need remains for effective bladder-preserving therapies. This review aims to describe existing treatments, contemporary research in this field and ongoing trials of salvage therapies for patients with BCG-unresponsive NMIBC. Recent findings Intravesical chemotherapy has been utilized frequently in this setting. Emerging data on combination regimens such as intravesical gemcitabine and docetaxel and intravesical cabazitaxel, gemcitabine and cisplatin are promising; nevertheless, larger, prospective trials are needed. Meanwhile, the intravenous checkpoint inhibitor pembrolizumab was recently FDA-approved for patients BCG-unresponsive NMIBC. Encouraging clinical trial results for intravesical nadofaragene firadenovec, oportuzumab monatox and ALT-803 + BCG have been released, while data from trials of other treatment strategies, including novel chemotherapy and drug delivery, augmented BCG immunotherapy, adenoviral and gene therapy, targeted therapy, and combination systemic immunotherapy with intravesical agents, are eagerly awaited. Several novel salvage therapies offer promise for patients with BCG-unresponsive NMIBC. Patient selection, efficacy, safety, cost and ease of administration must be carefully considered to determine the optimal treatment approach.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Packiam, Vignesh T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Richards, Jordan UNSPECIFIED UNSPECIFIED UNSPECIFIED Schmautz, Maximilian UNSPECIFIED UNSPECIFIED UNSPECIFIED Heidenreich, Axel UNSPECIFIED UNSPECIFIED UNSPECIFIED Boorjian, Stephen A. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-582652
DOI:	10.1097/MOU.0000000000000863
Journal or Publication Title:	Curr. Opin. Urol.
Volume:	31
Number:	3
Page Range:	S. 178 - 188
Date:	2021
Publisher:	LIPPINCOTT WILLIAMS & WILKINS
Place of Publication:	PHILADELPHIA
ISSN:	1473-6586
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CARCINOMA IN-SITU; PHASE-II TRIAL; SEQUENTIAL INTRAVESICAL GEMCITABINE; ALBUMIN-BOUND PACLITAXEL; UROTHELIAL CARCINOMA; ONCOLYTIC ADENOVIRUS; MITOMYCIN-C; TREATMENT OPTIONS; URINARY-BLADDER; CLINICAL-TRIALS Multiple languages Urology & Nephrology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/58265