免疫检查点抑制剂在膀胱尿路上皮癌中的研究进展

Progress of immune checkpoint blockade treatment in bladder urothelial cell carcinoma

膀胱尿路上皮癌(UBC)是常见的恶性肿瘤,可分为非肌层浸润性尿路上皮癌(NMIUC)、肌层浸润性尿路上皮癌(MIUC)和转移性尿路上皮癌(mUC)。mUC的一线治疗方案是以铂类为基础的化疗。然而,很多患者因基础状况较差无法耐受化疗的不良反应。即使能够接受化疗的患者,其获益也往往十分有限。目前,对尿路上皮肿瘤免疫学特征的研究有了很大的进展,尤其是免疫检查点抑制剂的相关研究,有望优化UBC的一线和二线治疗。本文旨在对免疫检查点抑制剂的研究进展作一综述,包括免疫检查点抑制剂的作用原理、疗效评价标准、免疫检查点抑制剂的联合应用和早期应用的探索,以及药物的不良反应及其处理。

Bladder urothelial carcinoma(UBC) is one of the common malignant tumors, including non-muscle-invasive urothelial carcinoma(NMIUC), muscle-invasive urothelial carcinoma(MIUC) and metastatic urothelial carcinoma(mUC). The first-line treatment of mUC is platinum-based chemotherapy. However, many patients can’t tolerate chemotherapy’s side effects due to their poor baseline conditions. Even patients are able to endure such side effects, their benefits are likely to be limited. Luckily, the study of the immunological characteristics of urinary tract epithelium cancer has made great progress, especially immune checkpoint blockade related research, which has the potential to optimize UBC’s therapy. This paper is intended to review the progress of immune checkpoint blockade treatment in bladder urothelial cell carcinoma, including immune checkpoint blockade’s basic principle, the efficacy evaluation criteria, the combined use of immune checkpoint blockade, the application in early stage of tumor and the adverse reactions.