卡介苗无反应性非肌层浸润性膀胱癌的分子机制及治疗新策略:免疫治疗成为新选择?  

Molecular mechanisms and novel therapeutic strategies of BCG-unresponsive non-muscle invasive bladder cancer:Emerging immunotherapy has become a new choice?

作　　者：胡鑫明[1] 徐磊[1] 古军[1] 陈化磊[1] 吴挺明 许生 车宪平[1] HU Xin-ming;XU lei;GU Jun;CHEN Hua-lei;WU Ting-ming;XU Shen;CHE Xian-ping(Department of Urology, The Second Affiliated Hospital of Hainan Medical University, Haikou 571000, China)

机构地区：[1]海南医学院第二附属医院泌尿外科,海南海口571000

出　　处：《海南医学院学报》2020年第14期1105-1110,共6页Journal of Hainan Medical University

基　　金：海南省自然科学基金资助项目(819MS127)。

摘　　要：目的:高危非肌层浸润性膀胱(non-muscle invasive bladder cancer,NMIBC)具有较高的复发和疾病进展的风险。而当前尚缺乏行之有效的预防和治疗手段,尤其是对于那些卡介苗(BCG)治疗失败的患者。本文综述了BCG无反应性NMIBC的分子机制研究进展,并总结了以免疫治疗为代表的新兴治疗策略的现状和前景,为BCG无反应性NMIBC的免疫治疗提供理论基础。方法:笔者在PubMed及CNKI期刊全文数据库检索系统中搜索关键词"非肌层浸润性膀胱癌,卡介苗治疗失败,疾病复发,疾病进展,免疫治疗"共得到126条英文文献及538条中文文献,同时在ClinicalTrials.gov中查询相关的临床研究,最后将上述研究进行整合分析后得出结果。结果:免疫治疗在多种类型肿瘤中均开展临床研究,而单独使用、联合使用或序贯使用不同作用靶点的免疫治疗药物治疗BCG无反应性NMIBC均取得了一定的疗效,更多的临床研究还在继续进行。结论:免疫治疗目前是肿瘤治疗前沿,无论从生物学角度还是从临床治疗意义上,它在NMIBC患者中具有不可或缺的地位。期待未来有更多的免疫治疗的实验室和临床研究的开展。Objective High-risk non-invasive bladder cancer(NMIBC)has a high rate of recurrence and disease progression.At present,there are still insufficient effective prevention and treatment methods,especially for patients who have failed BCG treatment.This article reviews the research progress of the molecular mechanism of BCG unresponsive NMIBC,and summarizes the current status and prospects of emerging therapeutic strategies represented by immunotherapy,providing a theoretical basis for the immunotherapy of BCG non-reactive NMIBC.Methods To search the PubMed and CNKI journal full-text database search system for keywords"non-muscle invasive bladder cancer,BCG unresponsive,disease recurrence,disease progression,and immunotherapy"with 126 English and 538 Chinese articles.The literature,as well as the relevant clinical research in ClinicalTrials.gov,was integrated together to obtain the results.Results Immunotherapy was performed in various types of tumors,and the use of immunotherapeutic drugs with different oncotargets administered alone,sequentially or in combination for the treatment of BCG-unresponsive NMIBC achieved favorable effects,and more clinical research was still ongoing.Conclusion Immunotherapy is currently the most promising treatment for cancer,and it is indispensable for patients with NMIBC,both biologically and clinically.We look forward to more laboratory and clinical research in immunotherapy in the future.

关 键 词：卡介苗无反应性 非肌层浸润性膀胱癌 疾病进展 免疫治疗 

分 类 号：R737.14[医药卫生—肿瘤]