Nonmuscle invasive urothelial cancer — Bacillus Calmette–Guérin instillation or checkpoint inhibitor immunotherapy?

SummaryTo date, intravesical instillation of Bacillus Calmette –Guérin (BCG) is the standard adjuvant treatment for most intermediate- and all high-risk bladder nonmuscle invasive urothelial carcinomas (NMIBC) after complete transurethral resection. Although BCG immunotherapy successfully reduces both recurrence and progression rates in affected patients, th ere are certain limitations associated with its application. Major issues are the relatively high failure rate in up to 40% of patients, the adverse effects of the instillations, and the shortage in BCG supply, requiring concerted alternative strategies. Furthermore, radical cystectomy, the currentl y suggested salvage treatment for patients failing BCG therapy, is often an overtreatment for a significant proportion of patients. Checkpoint inhibitor (CKI) immunotherapy has proven to be highly effective in a subset of advanced bladder cancer patients and is currently tested in various clinical scenarios alone and in combination with BCG in the adjuvant setting. CKIs’ mechanism is to a large part similar to that reported for BCG—that is, activation of the immune system and elimination of cancer cells in the bladder. Furthermore, CKIs could synergistically enhance the effect of the im mune system attracted by BCG and are generally associated with acceptable rates of adverse reactions. Thus, they may represent an ideal alternative to or partner for BCG immunotherapy in NMIBC. In case th...
Source: Memo - Magazine of European Medical Oncology - Category: Cancer & Oncology Source Type: research

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h R Abstract The annual symposium of the German Research Association for Bladder Carcinoma (DFBK) was organized on February 7th and 8th, 2020, in Düsseldorf. On the first day, eight international guest speakers invited by the DFBK and the Department of Urology of the Heinrich Heine University Düsseldorf presented the current state of research on bladder cancer (BC). Topics were genomic changes and molecular classification in non-muscle-invasive and muscle-invasive BC, prospects and limits of proteome technology in urine diagnostics, function of chromatin regulators in bladder carcinogenesis, cellular rea...
Source: Der Urologe. Ausg. A - Category: Urology & Nephrology Authors: Tags: Urologe A Source Type: research
Purpose of review To report the available information on the current status and future direction of the use of checkpoint inhibitors as novel immunotherapeutic agents in bladder cancer. Recent findings In the past 3 years, five immunotherapies targeting programmed cell death 1 (Pembrolizumab and Durvalumab) or programmed cell death-ligand 1 (PD-L1) (Atezolizumab, nivolumab and Avelumab) pathways have been approved in second-line setting for patients who progressed during or after cisplatin-based chemotherapy. According to the most recent update, these patients should be PD-L1-positive to be eligible for immunotherapy....
Source: Current Opinion in Urology - Category: Urology & Nephrology Tags: BLADDER CANCER: Edited by Juan Palou and Óscar Rodríguez Faba Source Type: research
We present a patient diagnosed with metastatic urothelial carcinoma who progressed while on cisplatin/gemcitabine chemotherapy in the form of oligometastasis to the bone. He has achieved a durable complete response with atezolizumab.
Source: Urology Case Reports - Category: Urology & Nephrology Source Type: research
Condition:   Bladder Cancer Intervention:   Other: No intervantion on patients. retrospective study is performed on paraffin embedded tumor tissue specimens routinely collected during TURBT. Sponsor:   Istituto Clinico Humanitas Recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
There is a great need to improve the outlook for people facing urinary bladder cancer, especially for patients with invasive urothelial carcinoma (InvUC) which is lethal in 50% of cases. Improved outcomes for patients with InvUC could come from advances on several fronts including emerging immunotherapies, targeted therapies, and new drug combinations; selection of patients most likely to respond to a given treatment based on molecular subtypes, immune signatures, and other characteristics; and prevention, early detection, and early intervention. Progress on all of these fronts will require clinically relevant animal model...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
Publication date: Available online 17 January 2020Source: European UrologyAuthor(s): Andrea Necchi, Russell Madison, Daniele Raggi, Joseph M. Jacob, Gennady Bratslavsky, Oleg Shapiro, Julia A. Elvin, Jo-Anne Vergilio, Jonathan K. Killian, Nhu Ngo, Shakti Ramkissoon, Eric Severson, Amanda C. Hemmerich, Richard Huang, Siraj M. Ali, Jon H. Chung, Prasanth Reddy, Vincent A. Miller, Alexa B. Schrock, Laurie M. GayAbstractBackgroundIn patients with rare histologies of bladder cancer, including adenocarcinoma of the bladder (ACB) and squamous-cell carcinoma (SCC), there are limited standard therapy options, defining an unmet medi...
Source: European Urology - Category: Urology & Nephrology Source Type: research
Bladder cancer is the most common cancer of the urinary system and its treatment has scarcely progressed for nearly 30 years. Advances in checkpoint inhibitor research have seemingly provided a new approach for treatment. However, there have been issues predicting immunotherapeutic biomarkers and identifying new therapeutic targets. We downloaded the gene expression profile and clinical data of 408 cases bladder urinary cancer from the Cancer Genome Atlas (TCGA) portal, and the abundance ratio of immune cells for each sample was obtained via the “Cell Type Identification by Estimating Relative Subsets of RNA Transcri...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
Conditions:   Bladder Urothelial Carcinoma;   Stage III Bladder Cancer AJCC v8;   Stage IIIA Bladder Cancer AJCC v8;   Stage IIIB Bladder Cancer AJCC v8 Interventions:   Drug: Carboplatin;   Drug: Cisplatin;   Drug: Doxorubicin;   Drug: Doxorubicin Hydrochloride;   Biological: Durvalumab;   Drug: Fluorouracil;   Drug: Gemcitabine;   Drug: Gemcitabine Hydrochloride;   Drug: Methotrexate;   Drug: Mitomycin;  ...
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
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