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中华腔镜泌尿外科杂志(电子版) ›› 2023, Vol. 17 ›› Issue (01) : 1 -6. doi: 10.3877/cma.j.issn.1674-3253.2023.01.001

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肌层浸润性膀胱癌新辅助与辅助免疫治疗的现状与展望
董文1,()   
  1. 1. 510288 广州,中山大学孙逸仙纪念医院泌尿外科
  • 收稿日期:2022-11-13 出版日期:2023-02-01
  • 通信作者: 董文
  • 基金资助:
    广东省自然科学基金面上项目(2019A1515010188); 国家自然科学基金面上项目(81972383)

Current status and prospect of neoadjuvant and adjuvant immunotherapy for muscle-invasive bladder cancer

Wen Dong1()   

  • Received:2022-11-13 Published:2023-02-01
  • Corresponding author: Wen Dong
引用本文:

董文. 肌层浸润性膀胱癌新辅助与辅助免疫治疗的现状与展望[J]. 中华腔镜泌尿外科杂志(电子版), 2023, 17(01): 1-6.

Wen Dong. Current status and prospect of neoadjuvant and adjuvant immunotherapy for muscle-invasive bladder cancer[J]. Chinese Journal of Endourology(Electronic Edition), 2023, 17(01): 1-6.

根治性膀胱切除术(radical cystectomy,RC)是肌层浸润性膀胱癌(muscle-invasive bladder cancer,MIBC)的主要治疗方式,国内外指南推荐为T2~4aN0M0期及高危非肌层浸润性膀胱癌患者提供RC[1]。但MIBC患者接受RC后,仍有50%的患者出现术后复发[1],从新辅助和辅助治疗的层面减少复发,提高患者生存率和生活质量就显得尤其重要。新辅助和辅助化疗的研究已从二十世纪八十年代开展,推荐cT2~4aN0M0期MIBC患者采用以顺铂为基础的新辅助化疗,未行新辅助化疗的pT3~pT4或淋巴结转移的患者建议术后辅助化疗[1]。同时,新辅助和辅助放疗也有报道,但因高质量循证医学证据不充分,尚未广泛应用于临床。免疫治疗近几年来迅速发展,在晚期膀胱癌治疗中取得了惊人的临床效果,并且已经获得欧洲泌尿外科诊治指南等多国指南推荐;在新辅助和辅助治疗中,以纳武单抗为代表的免疫治疗已经被指南推荐作为局部进展期膀胱癌辅助治疗的标准治疗,研究免疫治疗在新辅助治疗中疗效的多项临床试验已经完成或者正在进行中,新辅助与辅助免疫治疗已经成为了MIBC研究热点。

表1 进行中的部分免疫单药治疗肌层浸润性膀胱癌的研究
表2 进行中的新辅助双药免疫治疗肌层浸润性膀胱癌的研究
表3 进行中的新辅助免疫联合化疗治疗肌层浸润性膀胱癌的研究
表4 进行中的新辅助免疫联合靶向治疗肌层浸润性膀胱癌的研究
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