局部晚期或转移性尿路上皮癌免疫治疗的进展与思考
Immunotherapy for locally advanced or metastatic urothelial carcinoma: research advances and perspectives
摘要尿路上皮癌是常见的泌尿系恶性肿瘤。含铂化疗方案作为局部晚期或转移性尿路上皮癌的标准一线治疗虽有效,但部分患者无法耐受,且存在复发风险。免疫治疗为尿路上皮癌患者带来了新的治疗策略,免疫检查点抑制剂极大提升了临床疗效和生存获益,目前已有用于局部晚期或转移性尿路上皮癌治疗的报道。近年来,学者们对各种含免疫检查点抑制剂的联合治疗策略在不可手术的局部晚期或转移性尿路上皮癌患者中的应用进行探索,结果显示其疗效确切,不仅为临床治疗提供了更多选择,也成为未来尿路上皮癌联合治疗和精准治疗的重要方向。
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abstractsUrothelial carcinoma is the common malignancy involving the urinary system. Cisplatin-based chemotherapy is the initial regimen of choice for cisplatin-eligible patients with metastatic urothelial carcinoma. However, due to toxicity, the regimen is not well tolerated in part of the patients, such as in elderly patients or those with multiple complications, and there is still a risk of recurrence. During the past years, immune checkpoint inhibitors (ICI) have become available as a new option for urothelial carcinoma patients, with the benefits of clinical efficacy and quality of life. Development and researches of the ICI axis blockade have changed the contemporary treatment paradigm for patients with locally advanced or metastatic urothelial carcinoma. In addition, multiple clinical studies of combined treatment strategies of ICI have been explored recently. It is necessary to further understand the clinical value of ICI through summarizing the evidence supporting the use of checkpoint inhibitors for patients with inoperable locally advanced or metastatic urothelial carcinoma, which also may helpful to perspective the future research direction of combined strategies and precision medicine in urothelial carcinoma immunotherapy.
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