Immune therapies in non-muscle invasive bladder cancer

Current Treatment Options in Oncology
Philip L HoAshish M Kamat

Abstract

Non-muscle invasive bladder cancer (NMIBC) continues to be a challenging disease to manage. Treatment involves transurethral resection and, often, intravesical therapy. Appropriate patient selection, accurate staging, and morphological characterization are vital in risk-stratifying patients to those who would most benefit from receiving intravesical therapy. Bacillus of Calmette and Guérin (BCG) continues to be the first-line agent of choice for patients with intermediate- and high-risk NMIBC. Treatment should begin with the standard induction course of 6 weekly treatments. The inclusion of subsequent maintenance courses of BCG is imperative to optimal therapeutic response. While patients with intermediate-risk disease should receive 1 year of maintenance therapy, high-risk patients benefit from up to 3 years of maintenance therapy. BCG use should not be used in low-risk patients with de novo Ta, low-grade, solitary, <3-cm tumors. Conversely, patients with muscle-invasive disease should forgo intravesical immunotherapy and proceed directly to radical cystectomy. Cystectomy also should be considered in patients with multiple T1 tumors, T1 tumors located in difficult to resect locations, residual T1 on re-resection, and T1 with c...Continue Reading

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Citations

Nov 18, 2018·Bladder Cancer·Jean V JosephDonald Trump
Aug 16, 2017·Journal for Immunotherapy of Cancer·Ashish M KamatJonathan E Rosenberg
Oct 28, 2019·Frontiers in Immunology·Madhav V Dhodapkar, Kavita M Dhodapkar
Oct 17, 2021·Journal of Hematology & Oncology·Yiyin ZhangHui Lin

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