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Neoadjuvant Immunotherapy for Muscle-Invasive Bladder Cancer
Background and Objectives: Facing neoadjuvant chemotherapy followed by surgery, neoadjuvant immunotherapy is an innovative concept in localized muscle-invasive bladder cancer. Herein, we performed a review of the available and ongoing evidence supporting immune checkpoint inhibitor (ICI) administrat...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8398505/ https://www.ncbi.nlm.nih.gov/pubmed/34440975 http://dx.doi.org/10.3390/medicina57080769 |
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author | Peyrottes, Arthur Ouzaid, Idir Califano, Gianluigi Hermieu, Jean-Francois Xylinas, Evanguelos |
author_facet | Peyrottes, Arthur Ouzaid, Idir Califano, Gianluigi Hermieu, Jean-Francois Xylinas, Evanguelos |
author_sort | Peyrottes, Arthur |
collection | PubMed |
description | Background and Objectives: Facing neoadjuvant chemotherapy followed by surgery, neoadjuvant immunotherapy is an innovative concept in localized muscle-invasive bladder cancer. Herein, we performed a review of the available and ongoing evidence supporting immune checkpoint inhibitor (ICI) administration in the early stages of bladder cancer treatment. Materials and Methods: A literature search was performed on Medline and clinical trials databases, using the terms: “bladder cancer” OR “urothelial carcinoma”, AND “neoadjuvant immunotherapy” OR “preoperative immunotherapy”. We restricted our investigations to prospective clinical trials evaluating anti-PD-(L)1 and anti-CTLA-4 monoclonal antibodies. Data on efficacy, toxicity and potential biomarkers of response were retrieved. Results: The search identified 6 ICIs that were tested in the neoadjuvant setting for localized bladder cancer—4 anti-PD-(L)1 inhibitors (Pembrolizumab, Atezolizumab, Nivolumab and Durvalumab) and 2 anti-CTLA-4 inhibitors (Ipilimumab and Tremelimumab). Most of the existing literature was based on single-arm phase 2 clinical trials that included from 23 to 143 patients. The pathological complete response rate (pCR) and pathological response rate (pRR) ranged from 31% to 46% and from 55.9% to 66%, respectively. Survival data were immature at this time. The safety profile was acceptable, with severe treatment-related adverse events ranging from 6% to 41%. Conclusions: The results of early phase trials are encouraging, and more investigations are needed to strengthen the rationale for immune checkpoint inhibitor administration in localized muscle-invasive bladder cancer. |
format | Online Article Text |
id | pubmed-8398505 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-83985052021-08-29 Neoadjuvant Immunotherapy for Muscle-Invasive Bladder Cancer Peyrottes, Arthur Ouzaid, Idir Califano, Gianluigi Hermieu, Jean-Francois Xylinas, Evanguelos Medicina (Kaunas) Review Background and Objectives: Facing neoadjuvant chemotherapy followed by surgery, neoadjuvant immunotherapy is an innovative concept in localized muscle-invasive bladder cancer. Herein, we performed a review of the available and ongoing evidence supporting immune checkpoint inhibitor (ICI) administration in the early stages of bladder cancer treatment. Materials and Methods: A literature search was performed on Medline and clinical trials databases, using the terms: “bladder cancer” OR “urothelial carcinoma”, AND “neoadjuvant immunotherapy” OR “preoperative immunotherapy”. We restricted our investigations to prospective clinical trials evaluating anti-PD-(L)1 and anti-CTLA-4 monoclonal antibodies. Data on efficacy, toxicity and potential biomarkers of response were retrieved. Results: The search identified 6 ICIs that were tested in the neoadjuvant setting for localized bladder cancer—4 anti-PD-(L)1 inhibitors (Pembrolizumab, Atezolizumab, Nivolumab and Durvalumab) and 2 anti-CTLA-4 inhibitors (Ipilimumab and Tremelimumab). Most of the existing literature was based on single-arm phase 2 clinical trials that included from 23 to 143 patients. The pathological complete response rate (pCR) and pathological response rate (pRR) ranged from 31% to 46% and from 55.9% to 66%, respectively. Survival data were immature at this time. The safety profile was acceptable, with severe treatment-related adverse events ranging from 6% to 41%. Conclusions: The results of early phase trials are encouraging, and more investigations are needed to strengthen the rationale for immune checkpoint inhibitor administration in localized muscle-invasive bladder cancer. MDPI 2021-07-29 /pmc/articles/PMC8398505/ /pubmed/34440975 http://dx.doi.org/10.3390/medicina57080769 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Review Peyrottes, Arthur Ouzaid, Idir Califano, Gianluigi Hermieu, Jean-Francois Xylinas, Evanguelos Neoadjuvant Immunotherapy for Muscle-Invasive Bladder Cancer |
title | Neoadjuvant Immunotherapy for Muscle-Invasive Bladder Cancer |
title_full | Neoadjuvant Immunotherapy for Muscle-Invasive Bladder Cancer |
title_fullStr | Neoadjuvant Immunotherapy for Muscle-Invasive Bladder Cancer |
title_full_unstemmed | Neoadjuvant Immunotherapy for Muscle-Invasive Bladder Cancer |
title_short | Neoadjuvant Immunotherapy for Muscle-Invasive Bladder Cancer |
title_sort | neoadjuvant immunotherapy for muscle-invasive bladder cancer |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8398505/ https://www.ncbi.nlm.nih.gov/pubmed/34440975 http://dx.doi.org/10.3390/medicina57080769 |
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