RESUMO
Prior to the past decade, systemic therapy options for muscle-invasive bladder cancer (MIBC) or locally advanced/metastatic urothelial carcinoma (la/mUC) were dismal for cisplatin-ineligible patients and after progression on chemotherapy. Although the bulk of available evidence for novel systemic therapies exists in the la/mUC setting, emerging data suggests an important role in the neoadjuvant and adjuvant spaces as well. In this narrative review, we examine the application of contemporary systemic therapies to urothelial carcinoma (UC) including immune checkpoint inhibitors (ICIs), antibody-drug conjugates (ADCs), and targeted therapies. We additionally acknowledge the potential of combination therapies to further potentiate a durable synergistic response.
Assuntos
Carcinoma de Células de Transição , Neoplasias da Bexiga Urinária , Humanos , Neoplasias da Bexiga Urinária/tratamento farmacológico , Neoplasias da Bexiga Urinária/patologia , Carcinoma de Células de Transição/tratamento farmacológico , Carcinoma de Células de Transição/patologia , Cisplatino/uso terapêutico , Terapia Combinada , ImunoterapiaRESUMO
Systemic agents including immune checkpoint inhibitors, antibody-drug conjugates, and targeted therapies play a critical role in the management of bladder cancer. Novel localized delivery mechanisms for existing systemic agents explore solutions to improve treatment response without compromising safety. Herein, we review the contemporary innovations in modern intravesical agents, hyperthermic drug delivery, reverse-thermal gels, nanocarriers, gene therapy, and subcutaneous therapies.