Experimental and New Approaches for Bladder Preservation in Intermediate and High-Risk Non-Muscle-Invasive Bladder Cancer (NMIBC).
Natália D AvilezDiego M CapibaribeLeonardo Oliveira ReisPublished in: Research and reports in urology (2024)
About 75% of bladder cancers are detected as non-muscle invasive. High-risk patients have high progression risk. Although the standard is transurethral resection of bladder tumor plus full dose intravesical BCG for one to 3 years, due to the high risk of progression, radical cystectomy may be considered in specific cases. Although radical cystectomy is still the best approach for high-grade NMIBC from an oncological perspective, its high morbidity and impact on quality of life motivate studies of new strategies that may reduce the need for cystectomy. We carried out a mini-review whose objectives were: 1 - to identify bladder-sparing alternatives that are being studied as possible treatment for patients with intermediate and high-risk NMIBC; 2 - understand the evidence that exists regarding success rate, follow-up, and side effects of different strategies. Several studies have sought alternatives for bladder preservation, including immunotherapy, intravesical chemotherapy, chemo-hyperthermia, antibody-drug conjugates, viral genetic therapy, and others with promising results. The selection of an optimal therapy for high-risk NMIBC that can reduce the need for cystectomy, with low toxicity and high efficacy, is of paramount importance and remains an issue, however, several known medications are being tested as bladder-preserving alternatives in this scenario and have shown promise in studies.
Keyphrases
- muscle invasive bladder cancer
- spinal cord injury
- urinary tract
- robot assisted
- high grade
- end stage renal disease
- ejection fraction
- neoadjuvant chemotherapy
- case control
- skeletal muscle
- sars cov
- chronic kidney disease
- prostate cancer
- oxidative stress
- cancer therapy
- peritoneal dialysis
- gene expression
- mesenchymal stem cells
- artificial intelligence
- big data
- replacement therapy
- patient reported outcomes
- rectal cancer
- lymph node
- oxide nanoparticles
- chemotherapy induced