TY - JOUR
T1 - BCG-Unresponsive Non-Muscle-Invasive Bladder Cancer
T2 - Current Treatment Landscape and Novel Emerging Molecular Targets
AU - Claps, Francesco
AU - Pavan, Nicola
AU - Ongaro, Luca
AU - Tierno, Domenico
AU - Grassi, Gabriele
AU - Trombetta, Carlo
AU - Tulone, Gabriele
AU - Simonato, Alchiede
AU - Bartoletti, Riccardo
AU - Mertens, Laura S.
AU - van Rhijn, Bas W. G.
AU - Mir, Maria Carmen
AU - Scaggiante, Bruna
N1 - Publisher Copyright: © 2023 by the authors.
PY - 2023/8/1
Y1 - 2023/8/1
N2 - Urothelial carcinoma (UC), the sixth most common cancer in Western countries, includes upper tract urothelial carcinoma (UTUC) and bladder carcinoma (BC) as the most common cancers among UCs (90–95%). BC is the most common cancer and can be a highly heterogeneous disease, including both non-muscle-invasive (NMIBC) and muscle-invasive (MIBC) forms with different oncologic outcomes. Approximately 80% of new BC diagnoses are classified as NMIBC after the initial transurethral resection of the bladder tumor (TURBt). In this setting, intravesical instillation of Bacillus Calmette–Guerin (BCG) is the current standard treatment for intermediate- and high-risk patients. Unfortunately, recurrence occurs in 30% to 40% of patients despite adequate BCG treatment. Radical cystectomy (RC) is currently considered the standard treatment for NMIBC that does not respond to BCG. However, RC is a complex surgical procedure with a recognized high perioperative morbidity that is dependent on the patient, disease behaviors, and surgical factors and is associated with a significant impact on quality of life. Therefore, there is an unmet clinical need for alternative bladder-preserving treatments for patients who desire a bladder-sparing approach or are too frail for major surgery. In this review, we aim to present the strategies in BCG-unresponsive NMIBC, focusing on novel molecular therapeutic targets.
AB - Urothelial carcinoma (UC), the sixth most common cancer in Western countries, includes upper tract urothelial carcinoma (UTUC) and bladder carcinoma (BC) as the most common cancers among UCs (90–95%). BC is the most common cancer and can be a highly heterogeneous disease, including both non-muscle-invasive (NMIBC) and muscle-invasive (MIBC) forms with different oncologic outcomes. Approximately 80% of new BC diagnoses are classified as NMIBC after the initial transurethral resection of the bladder tumor (TURBt). In this setting, intravesical instillation of Bacillus Calmette–Guerin (BCG) is the current standard treatment for intermediate- and high-risk patients. Unfortunately, recurrence occurs in 30% to 40% of patients despite adequate BCG treatment. Radical cystectomy (RC) is currently considered the standard treatment for NMIBC that does not respond to BCG. However, RC is a complex surgical procedure with a recognized high perioperative morbidity that is dependent on the patient, disease behaviors, and surgical factors and is associated with a significant impact on quality of life. Therefore, there is an unmet clinical need for alternative bladder-preserving treatments for patients who desire a bladder-sparing approach or are too frail for major surgery. In this review, we aim to present the strategies in BCG-unresponsive NMIBC, focusing on novel molecular therapeutic targets.
KW - Bacillus Calmette–Guérin-unresponsive non-muscle-invasive bladder cancer
KW - bladder sparing treatment
KW - chemo-hyperthermia
KW - gene therapy
KW - immunotherapy
KW - non-muscle-invasive bladder cancer
KW - photodynamic therapy
UR - http://www.scopus.com/inward/record.url?scp=85168740072&partnerID=8YFLogxK
U2 - https://doi.org/10.3390/ijms241612596
DO - https://doi.org/10.3390/ijms241612596
M3 - Review article
C2 - 37628785
SN - 1661-6596
VL - 24
JO - International journal of molecular sciences
JF - International journal of molecular sciences
IS - 16
M1 - 12596
ER -