Many patients with non-muscle-invasive bladder cancer (NMIBC) failed intravesical BCG therapy. Currently, radical cystectomy is the recommended standard of care for those patients. There is unfortunately no effective other second-line therapy recommended.
In this review, we present the topics of BCG unresponsive NMIBC; definition, prognosis, and further treatment options: immunotherapy, intravesical chemotherapy, gene therapy, and targeted individualized therapy.
There are major challenges of the management of NMIBC who failed BCG therapy as many patients refuse or are unfit for radical cystectomy. Multiple new modalities currently under investigation in ongoing clinical trials to better treat this category of patients. Immunotherapy, especially PD-1/PD-L1 inhibitors, offers exciting and potentially effective strategies for the treatment of BCG unresponsive NMIBC. As the data expands, it is sure that soon there will be established new guidelines for NMIBC.
Expert review of anticancer therapy. 2020 Sep 11 [Epub ahead of print]
Mohamad Moussa, Athanasios G Papatsoris, Athanasios Dellis, Mohamed Abou Chakra, Wajih Saad
Head of Urology department, Zahraa Hospital, University Medical Center, Lebanese University , Beirut, Lebanon., 2nd Department of Urology, School of Medicine, Sismanoglio Hospital, National and Kapodistrian University of Athens , Athens, Greece., Department of Surgery, School of Medicine, Aretaieion Hospital, National and Kapodistrian University of Athens , Athens, Greece., Faculty of Medical Sciences, department of Urology, Lebanese University , Beirut,Lebanon., Head of Oncology department, Zahraa Hospital, University Medical Center, Lebanese University , Beirut, Lebanon.