Immunotherapy for non-muscle-invasive bladder cancer: from the origins of BCG to novel therapies.
Samantha R Unsworth-WhiteMark O KitchenRichard T BryanPublished in: Future oncology (London, England) (2021)
Supplies of intravesical Bacillus Calmette-Guérin (BCG), the first-line treatment for most intermediate- and high-risk non-muscle-invasive bladder cancers (NMIBC), have proven unreliable over the past decade. This review considers the evolution of BCG immunotherapy for NMIBC: from the discovery of the antitumour side effects of tuberculosis and subsequently the BCG vaccine, to recent advances in novel immunotherapeutic agents. We summarize the evidence for alternative options to standard intravesical BCG therapy regimens and describe the potential for immune response manipulating drugs in the treatment of NMIBC. These new agents, including immune checkpoint inhibitors, toll-like receptor agonists and recombinant viral vectors, may provide better options in the management of NMIBC in the future.
Keyphrases
- muscle invasive bladder cancer
- toll like receptor
- immune response
- nuclear factor
- inflammatory response
- mycobacterium tuberculosis
- sars cov
- small molecule
- spinal cord injury
- risk assessment
- emergency department
- current status
- high throughput
- hepatitis c virus
- climate change
- human immunodeficiency virus
- antiretroviral therapy
- smoking cessation
- gene therapy
- bone marrow
- electronic health record