晚期膀胱癌免疫治疗潜在的生物标志物研究进展

Research progress of potential biomarkers for immunotherapy of advanced bladder cancer

肌层浸润性膀胱癌(MIBC)患者预后较差,5年总生存率为40%~50%。对于局限性MIBC患者,新辅助化疗联合根治性膀胱切除术是其主要治疗方式;而对于转移性膀胱癌仅能通过姑息性全身化疗或免疫治疗进行治疗。随着免疫相关研究的进展,免疫治疗逐渐成为晚期癌症治疗的研究热点,也取得一定的突破性进展。膀胱癌被认为是目前对免疫治疗最为敏感的泌尿系肿瘤,已开展了很多探索晚期膀胱癌免疫治疗潜在生物标志物的研究。但是目前临床还没有哪种生物标志物具有足够的证据证明其常规使用的合理性。近年来,针对膀胱癌免疫治疗潜在的生物标志物研究主要包括肿瘤细胞相关和肿瘤微环境相关2个方面。本文主要讨论这些生物标志物,并深入了解其潜在的价值,以便为制定临床治疗决策提供有用信息,最终改善膀胱癌患者的预后。

The prognosis of patients with muscle-invasive bladder cancer(MIBC) is poor, and the 5-year overall survival rate is 40%-50%. For patients with localized MIBC, neoadjuvant chemotherapy combined with radical cystectomy is the main treatment. However, metastatic bladder cancer can only be treated with palliative systemic chemotherapy or immunotherapy. With the development of immune-related research, immunotherapy has gradually become a research hotspot in the treatment of advanced cancer, and made some breakthrough progress. Bladder cancer is considered to be the most sensitive urological malignancy to immunotherapy. Many studies related to immunotheapy have been carried out to explore potential biomarkers of immunotherapy for advanced bladder cancer. However, no consistent biomarker has been justified its routine use. In recent years, studies on potential biomarkers of immunotherapy for bladder cancer mainly include two aspects: tumor cell correlation and tumor microenvironment correlation.In this article, we discuss these biomarkers and gain insight into their potential value in order to provide useful information for making clinical treatment decisions and ultimately improve the prognosis of bladder cancer patients.