非肌层浸润性膀胱癌的免疫治疗

Immunotherapy for non-muscle-invasive bladder cancer

膀胱癌是泌尿生殖系统常见的恶性肿瘤,中、高危非肌层浸润性膀胱癌的标准治疗方式为经尿道膀胱肿瘤切除术+膀胱灌注治疗。在众多膀胱灌注药物中,BCG膀胱灌注以其明显的抗肿瘤疗效得到广泛使用。但部分高危患者即使进行了BCG标准灌注治疗,仍会发生膀胱癌复发和/或进展,且后续可供选择的治疗方式很少。近几年随着肿瘤免疫学研究的进展,新型免疫治疗药物的开发为膀胱癌的治疗带来了重大突破。此文对非肌层浸润性膀胱癌经尿道膀胱肿瘤切除术后,BCG等免疫调节剂膀胱灌注及灌注治疗失败后的免疫治疗方法进行综述。

Bladder cancer is a common malignant tumor of urogenital system.Transurethral resection of bladder tumour (TURBT)+ intravesical instillation therapy is the standard treatment for medium-and high-risk non-muscle-invasive bladder cancer.Among various intravesical therapies, intravesical BCG instillation has been widely used for its significant anti-tumor efficacy. However, some high-risk patients have experienced recurrence and/or progression of bladder cancer even after BCG standard therapy, with few therapy choices afterwords. Lately, with the research progress on tumor immunology, the development of new immunotherapeutic drugs has brought significant breakthrough for the treatment of bladder cancer. This paper reviews the intravesical instillation therapies such as BCG after TURBT for non-muscular invasive bladder cancer, and immunotherapies after the failure of BCG therapy.