Erschienen in:
03.07.2018 | Urologic Oncology
Cancer Immune Therapy: Prognostic Significance and Implications for Therapy of PD-1 in BCG-Relapsing Bladder Cancer
verfasst von:
Neelam Mukherjee, PhD, Robert Svatek, MD, MSCI
Erschienen in:
Annals of Surgical Oncology
|
Ausgabe 9/2018
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Excerpt
Bacillus Calmette–Guérin (BCG) immune therapy is used for (1) preventing bladder cancer relapse following complete tumor excision of Ta and T1 papillary tumors, and (2) eradication of carcinoma in situ (CIS), which is not usually completely removed due to its diffuse and often multifocal involvement of the bladder. Tumors that relapse despite adequate BCG are often aggressive and life-threatening if not managed appropriately. Thus, radical cystectomy is the gold standard for BCG failures. Alternatives to cystectomy include intravesical valrubicin, which is US FDA-approved for BCG-unresponsive CIS and off-label approaches, including repeat instillation of BCG with or without interferon-α, or intravesical instillation of other immune or chemotherapeutic agents. Currently, a major obstacle in this field is the lack of understanding of immune regulatory pathways driving BCG responsiveness, making it difficult to understand why many patients do not respond to therapy. …
