Intravesical bacillus Calmette-Guérin (BCG) immunotherapy has been the gold standard adjuvant treatment for intermediate- and high-risk non-muscle-invasive bladder cancer (NMIBC) after transurethral resection of bladder tumor (TURBT). BCG immunotherapy prevents disease recurrence and progression to muscle-invasive disease following TURBT. Although most patients initially respond well to intravesical BCG, considerable concern has been raised for patients with BCG failure who are refractory or recur in 6 months after their last BCG, which implies 'BCG-unresponsiveness'. Based on current clinical guidelines, early radical cystectomy (RC) is recommended to treat BCG-unresponsive NMIBC. However, due to the high risk of morbidity and mortality of RC and patients' desire to preserve their own bladder, there is a critical unmet need for alternative conservative treatments as bladder-sparing strategies in BCG-unresponsive patients. Trials for effective bladder-sparing treatments are ongoing, and several novel agents have been recently tested in the NMIBC setting. The goal of this review is to introduce and summarize recently reported novel and emerging drugs and ongoing clinical trials for BCG-unresponsive NMIBC.
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http://dx.doi.org/10.4111/icu.20200602 | DOI Listing |
J Pak Med Assoc
January 2025
Department of Physiology, Karachi University, Karachi, Pakistan.
Bladder cancer remains a significant global health concern, being the 10th most common malignancy worldwide and the 6th most common neoplasia in males, with alarming annual incidence and mortality rates. The current narrative review was planned to delve into the multifaceted landscape of bladder cancer, exploring its epidemiology, risk factors and diagnostic modalities. While white light cystoscopy has long been considered the gold standard for bladder cancer diagnosis and surveillance, the emergence of blue light cystoscopy has ushered in a new era of early detection.
View Article and Find Full Text PDFEur Urol
January 2025
2nd Urology Department, Sismanoglion Hospital, National & Kapodistrian University of Athens, Athens, Greece.
For patients with high-risk non-muscle-invasive bladder cancer (NMIBC) for whom bacillus Calmette-Guérin (BCG) treatment has failed, bladder preservation is a high priority. Immune checkpoint inhibitors have shown promise, but systemic administration is associated with substantial toxicity. In this single-arm phase 2 study, 30 patients with NMIBC after BCG failure were treated with intravesical durvalumab every 6 wk.
View Article and Find Full Text PDFInt Urol Nephrol
January 2025
Department of Medical, Surgical and Neurological Science, University of Siena, Siena, Italy.
Purpose: Intravesical (i) immunotherapy with Bacillus Calmette-Guérin (BCG) is the recommended treatment for patients with intermediate- and high-risk non-muscle-invasive bladder cancer (NMIBC) after complete tumor resection. Discontinuation or suspension of this therapy is often due to local side effects. Aim of the study was to evaluate the efficacy and safety of sequential intravesical instillations of combined hyaluronic acid (HA) and chondroitin sulfate (CS) in reducing local BCG toxicity and urinary symptoms.
View Article and Find Full Text PDFUrol Oncol
January 2025
Vita-Salute San Raffaele University and IRCCS San Raffaele Hospital, Milan, Italy; Department of Medical Oncology, IRCCS San Raffaele University, Milan, Italy.
Treatment options for recurrent high-risk non-muscle-invasive bladder cancer (HR NMIBC) and muscle-invasive bladder cancer (MIBC) are limited, highlighting a need for clinically effective, accessible, and better-tolerated alternatives. In this review we examine the clinical development program of TAR-200, a novel targeted releasing system designed to provide sustained intravesical delivery of gemcitabine to address the needs of patients with NMIBC and of those with MIBC. We describe the concept and design of TAR-200 and the clinical development of this gemcitabine intravesical system in the SunRISe portfolio of studies.
View Article and Find Full Text PDFTransl Androl Urol
December 2024
Department of Urology, the First Hospital of Lanzhou University, Lanzhou, China.
Background: Bladder urothelial carcinoma (BLCA) is a highly heterogeneous cancer with a wide range of prognoses, ranging from low-grade non-muscle-invasive bladder cancer (NMIBC), which has a good prognosis but a high recurrence rate, to high-grade muscle-invasive bladder cancer (MIBC), which has a poor prognosis. Glycosylation dysregulation plays a significant role in cancer development. Therefore, this study aimed to investigate the role of glycosyltransferases (GT)-related genes in the prognosis of BLCA and to develop a prognostic model based on these genes to predict overall survival (OS) and assess its clinical application.
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