Developments in conservative treatment for BCG-unresponsive non-muscle invasive bladder cancer.

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  • Additional Information
    • Source:
      Publisher: Informa Healthcare Country of Publication: England NLM ID: 100897346 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1744-7666 (Electronic) Linking ISSN: 14656566 NLM ISO Abbreviation: Expert Opin Pharmacother Subsets: MEDLINE
    • Publication Information:
      Publication: London : Informa Healthcare
      Original Publication: London : Ashley Publications, c1999-
    • Subject Terms:
      BCG Vaccine*/therapeutic use ; Neoplasm Invasiveness* ; Non-Muscle Invasive Bladder Neoplasms*/pathology ; Non-Muscle Invasive Bladder Neoplasms*/therapy; Humans ; Adjuvants, Immunologic/therapeutic use ; Adjuvants, Immunologic/administration & dosage ; Administration, Intravesical ; Conservative Treatment ; Cystectomy ; Disease Progression ; Neoplasm Recurrence, Local/prevention & control
    • Abstract:
      Introduction: To reduce the risk of disease recurrence and progression of intermediate and high-risk Non-Muscle Invasive Bladder Cancers (NMIBCs), intravesical adjuvant treatment with Bacillus Calmette-Guerin (BCG) represents the standard of care, although up to 50% of patients will eventually recur and up to 20% of them will progress to Muscle Invasive Bladder Cancer (MIBC). Radical Cystectomy (RC) is the treatment of choice in this setting; however, this represents a major and morbid surgery, thus meaning that not all NMIBCs patient could undergo or may refuse this procedure or may refuse. The search for effective bladder sparing strategies in NMIBCs BCG-unresponsive patients is a hot topic in the urologic field.
      Areas Covered: We aimed to review the most important bladder-preserving strategies for BCG unresponsive disease, from those used in the past, even though rarely used nowadays (intravesical chemotherapy with single agents), to current available therapies (e.g. intravesical instillation with Gemcitabine-Docetaxel), and to future upcoming treatments (Oportuzumab Monatox).
      Expert Opinion: At present, bladder-preserving treatments in BCG-unresponsive patients are represented by the use of intravesical instillations, systemic immunotherapies, both with good short-term and modest mid-term efficacy, and numerous clinical trials ongoing, with encouraging initial results, in which patients could be recruited.
    • Contributed Indexing:
      Keywords: BCG; BCG-Unresponsive NMIBC; NMIBC; bladder cancer; immunotherapy; intravesical instillation
    • Accession Number:
      0 (Adjuvants, Immunologic)
      0 (BCG Vaccine)
    • Publication Date:
      Date Created: 20240806 Date Completed: 20240820 Latest Revision: 20240826
    • Publication Date:
      20240827
    • Accession Number:
      10.1080/14656566.2024.2380469
    • Accession Number:
      39104019