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Pharmacologic Therapies for Non-Muscle Invasive Bladder Cancer: Current and Future Treatments

Bladder cancer is the sixth most common malignancy in the United States and 70% of cases are non-muscle invasive at the time of diagnosis. Effective treatment is crucial to prevent progression, which occurs in about 30% of patients. The American Urological Association (AUA) guidelines recommend trea...

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Autores principales: Goldberg, Ilana P., Lichtbroun, Benjamin, Singer, Eric A., Ghodoussipour, Saum
Formato: Online Artículo Texto
Lenguaje:English
Publicado: 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9431226/
https://www.ncbi.nlm.nih.gov/pubmed/36051251
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author Goldberg, Ilana P.
Lichtbroun, Benjamin
Singer, Eric A.
Ghodoussipour, Saum
author_facet Goldberg, Ilana P.
Lichtbroun, Benjamin
Singer, Eric A.
Ghodoussipour, Saum
author_sort Goldberg, Ilana P.
collection PubMed
description Bladder cancer is the sixth most common malignancy in the United States and 70% of cases are non-muscle invasive at the time of diagnosis. Effective treatment is crucial to prevent progression, which occurs in about 30% of patients. The American Urological Association (AUA) guidelines recommend treatment of non-muscle invasive bladder cancer (NMIBC) with intravesical Bacille Calmette-Guerin (BCG) and chemotherapy. However, ongoing shortages and high rates of BCG unresponsiveness creates a major need for novel therapies. In this narrative review, we discuss the evolving landscape of therapeutic options for NMIBC. Pembrolizumab, an anti-programmed cell death (PD)-1 antibody, was the first systemic therapy to be FDA-approved for BCG-unresponsive, high-risk disease. Promising new agents under investigation include various other checkpoint inhibitors and adenovirus-based therapies including CG0070 and nadofaragene firadenovec (rAd-IFNa/Syn3). Finally, new mechanisms of drug delivery are under investigation, including delivery with the GemRIS (TAR-200) device and delivery of intravesical chemotherapy at higher temperatures. With the promise of novel therapies on the horizon, we can expect the role of urologists in the management of NMIBC to evolve and expand.
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spelling pubmed-94312262022-08-31 Pharmacologic Therapies for Non-Muscle Invasive Bladder Cancer: Current and Future Treatments Goldberg, Ilana P. Lichtbroun, Benjamin Singer, Eric A. Ghodoussipour, Saum Arch Pharmacol Ther Article Bladder cancer is the sixth most common malignancy in the United States and 70% of cases are non-muscle invasive at the time of diagnosis. Effective treatment is crucial to prevent progression, which occurs in about 30% of patients. The American Urological Association (AUA) guidelines recommend treatment of non-muscle invasive bladder cancer (NMIBC) with intravesical Bacille Calmette-Guerin (BCG) and chemotherapy. However, ongoing shortages and high rates of BCG unresponsiveness creates a major need for novel therapies. In this narrative review, we discuss the evolving landscape of therapeutic options for NMIBC. Pembrolizumab, an anti-programmed cell death (PD)-1 antibody, was the first systemic therapy to be FDA-approved for BCG-unresponsive, high-risk disease. Promising new agents under investigation include various other checkpoint inhibitors and adenovirus-based therapies including CG0070 and nadofaragene firadenovec (rAd-IFNa/Syn3). Finally, new mechanisms of drug delivery are under investigation, including delivery with the GemRIS (TAR-200) device and delivery of intravesical chemotherapy at higher temperatures. With the promise of novel therapies on the horizon, we can expect the role of urologists in the management of NMIBC to evolve and expand. 2022 /pmc/articles/PMC9431226/ /pubmed/36051251 Text en https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Article
Goldberg, Ilana P.
Lichtbroun, Benjamin
Singer, Eric A.
Ghodoussipour, Saum
Pharmacologic Therapies for Non-Muscle Invasive Bladder Cancer: Current and Future Treatments
title Pharmacologic Therapies for Non-Muscle Invasive Bladder Cancer: Current and Future Treatments
title_full Pharmacologic Therapies for Non-Muscle Invasive Bladder Cancer: Current and Future Treatments
title_fullStr Pharmacologic Therapies for Non-Muscle Invasive Bladder Cancer: Current and Future Treatments
title_full_unstemmed Pharmacologic Therapies for Non-Muscle Invasive Bladder Cancer: Current and Future Treatments
title_short Pharmacologic Therapies for Non-Muscle Invasive Bladder Cancer: Current and Future Treatments
title_sort pharmacologic therapies for non-muscle invasive bladder cancer: current and future treatments
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9431226/
https://www.ncbi.nlm.nih.gov/pubmed/36051251
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