Immunotherapy in Bladder Cancer: Present and Future
DOI:
https://doi.org/10.48193/revistamexicanadeurologa.v80i6.651Keywords:
bladder tumor, inmunotherapy, treatments, muscle-invasive, non-muscle-invasiveAbstract
Bladder cancer (BC) continues to be a challenge in current urologic clinical practice. It is the seventh most frequently diagnosed tumor in men worldwide, and the eleventh, if we include both men and women.
The treatment of non-muscle-invasive bladder cancer has limitations, starting with the approach: transurethral resection is not always complete, there can be failures or early recurrence after bacillus Calmette-Guérin (BCG) therapy, and side effects of treatment with BCG can force its suspension.
In cases of muscle-invasive bladder cancer (MIBC), radical cystectomy is not always a treatment option due to important perioperative comorbidity. In patients with metastatic bladder tumors, the side effects of conventional chemotherapy, as well as tumor progression, have resulted in the need for developing new therapies.
Advances in the knowledge of oncologic molecular biology have provided us with new therapeutic targets (such as cell cycle inhibitors), and specific drugs directed at them have been developed, through the use of monoclonal antibodies. At present, five drugs have been approved by the Food and Drug Administration and the European Medicines Agency for the treatment of metastatic MIBC: atezolizumab, nivolumab, and pembrolizumab stand out for their wider use in clinical practice.
The good results obtained in metastatic bladder cancer have led to the development of new lines of research for the use of those molecules at earlier disease stages and in neoadjuvant protocols. Likewise, numerous studies are being conducted on the combination of those new agents with conventional chemotherapy and radiotherapy to determine more adequate treatment regimens.
The present review article concisely describes the current state of immunotherapy in relation to bladder cancer.
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