Drug strategies for bladder cancer in the elderly: is there promise for the future?

Soria, Francesco; Mosca, Alessandra

doi:10.1080/14656566.2019.1615055

Cited by 2 publications

(3 citation statements)

References 69 publications

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“…Many BC trials are exploring immunotherapy, vaccines, chemotherapy, or gene therapy efficacy for BCG-unresponsive disease, advanced, recurrent, and metastatic BC. For a comprehensive list of drugs for several BC phenotypes, see Butt and Malik (2018), Rouanne et al (2018), and Soria et al (2019), while for specific NMIBCs, BCG-unresponsive, see Tse et al (2019). We included some clinical trials from no.…”

Section: Immunotherapy Of Bladder Cancer: New Frontiersmentioning

confidence: 99%

“…In highest-risk tumors, e.g., associated with concurrent bladder carcinoma in situ (CIS) and BCG failure, radical cystectomy is recommended (Babjuk et al, 2019). BCG immunotherapy ensures NMIBC treatment also in the elderly, not eligible for cisplatin systemic chemotherapy (Soria et al, 2019). Although BCG mode of action is still not completely understood, its efficacy in superficial bladder carcinoma might be achieved through the local enhancement of the immune response, recruitment of inflammatory cells, and release of cytokines (Lawrence et al, 2013;Song et al, 2019).…”

Section: Bacillus Calmette-guérin Intravesical Therapymentioning

confidence: 99%

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New Roadmaps for Non-muscle-invasive Bladder Cancer With Unfavorable Prognosis

et al. 2020

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About 70% of bladder cancers (BCs) are diagnosed as non-muscle-invasive BCs (NMIBCs), while the remaining are muscle-invasive BCs (MIBCs). The European Association of Urology (EAU) guidelines stratify NMIBCs into low, intermediate, and high risk for treatment options. Low-risk NMIBCs undergo only the transurethral resection of the bladder (TURB), whereas for intermediate-risk and high-risk NMIBCs, the transurethral resection of the bladder (TURB) with or without Bacillus Calmette-Guérin (BCG) immune or chemotherapy is the standard treatment. A minority of NMIBCs show unfavorable prognosis. High-risk NMIBCs have a high rate of disease recurrence and/or progression to muscle-invasive tumor and BCG treatment failure. The heterogeneous nature of NMIBCs poses challenges for clinical decision-making. In 2020, the EAU made some changes to NMIBCs BCG failure definitions and treatment options, highlighting the need for reliable molecular markers for improving the predictive accuracy of currently available risk tables. Nowadays, next-generation sequencing (NGS) has revolutionized the study of cancer biology, providing diagnostic, prognostic, and therapy response biomarkers in support of precision medicine. Integration of NGS with other cutting-edge technologies might help to decipher also bladder tumor surrounding aspects such as immune system, stromal component, microbiome, and urobiome; altogether, this might impact the clinical outcomes of NMBICs especially in the BCG responsiveness. This review focuses on NMIBCs with unfavorable prognoses, providing molecular prognostic factors from tumor immune and stromal cells, and the perspective of urobiome and microbiome profiling on therapy response. We provide information on the cornerstone of immunotherapy and new promising bladder-preserving treatments and ongoing clinical trials for BCG-unresponsive NMIBCs.

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Section: Immunotherapy Of Bladder Cancer: New Frontiersmentioning

confidence: 99%

Section: Bacillus Calmette-guérin Intravesical Therapymentioning

confidence: 99%

New Roadmaps for Non-muscle-invasive Bladder Cancer With Unfavorable Prognosis

et al. 2020

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“…In some cases, the disease has progressed to the point where curative treatment is no longer possible. The majority of individuals with this disease suffer from bothersome symptoms like dysuria and hematuria, which necessitate treatment for the length of the patient's life (6) .…”

Section: Introductionmentioning

confidence: 99%

Value of Low Dose Short Hypofractionated Palliative Radiation Therapy in the Management of Bladder Cancer

Mahmoud¹,

Mazrouh²,

Toam³

et al. 2022

The Egyptian Journal of Hospital Medicine

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Background: In locally advanced and metastatic urinary bladder carcinoma, palliative radiation therapy aims to palliate symptoms with acceptable toxicity. Objective: Evaluation of the role of low dose short hypofractionated radiotherapy in improving symptoms of bladder cancer indefinitely, as long as it does not cause unacceptable toxicity. Patients and Methods: From July 2018 to July 2020, 24 patients with advanced bladder cancer were included in a trial at Zagazig University Hospitals' Clinical Oncology & Nuclear Medicine Department. All patients received a total dose of 21Gy of conformal radiation (7 Gy/fraction in 3 fractions, a fraction every other day over one week). Results: There was statistically significant improvement in haematuria symptoms among the studied patients. Also, there were no statistically significant changes in bowel frequency symptoms, diarrhea symptoms and bleeding symptoms. There were no significant changes in symptoms at 3-month assessment compared to end of treatment assessment while there was increase in percent of patients with symptomatic improvements especially in haematuria, dysuria and nocturia symptoms. Conclusion: Low dose hypofractionated radiation therapy protocol showed effective palliation of urinary symptoms with an acceptable toxicity.

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Drug strategies for bladder cancer in the elderly: is there promise for the future?

Cited by 2 publications

References 69 publications

New Roadmaps for Non-muscle-invasive Bladder Cancer With Unfavorable Prognosis

New Roadmaps for Non-muscle-invasive Bladder Cancer With Unfavorable Prognosis

Value of Low Dose Short Hypofractionated Palliative Radiation Therapy in the Management of Bladder Cancer

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