Intravesical therapy for urothelial carcinoma of the urinary bladder: a critical review
Int. braz. j. urol
;
35(6): 640-651, Nov.-Dec. 2009.
Artículo
en Inglés
| LILACS
| ID: lil-536820
ABSTRACT
The management of non-muscle-invasive urothelial carcinoma of the bladder (UCB) is a challenge for physicians and patients alike. This is largely due to the heterogeneous natural history of this disease, in which tumors range from indolent to rapidly progressive and eventually fatal. Moreover, the high rate of recurrence and progression cause significant morbidity, expense, and detriment to quality of life. The advent of effective and safe intravesical therapies has improved the management of non-muscle-invasive UCB. Nevertheless, despite over 30 years of research and clinical experience, the mechanism, risks, benefits, and optimal regimens and treatment algorithms remain unclear. Although immunotherapy with bacillus Calmette-Guerin (BCG) has been the mainstay of intravesical treatment and represents a significant advance in the interaction of immunology and oncology, its clinical effectiveness is accompanied by a wide range of adverse events. Here, we review the literature on intravesical immunotherapy and chemotherapy with the aim of evaluating the clinical utility of the different treatments and providing recommendations. Many studies over the years have compared efficacy and toxicities of different agents and regimens, and certain conclusions are now well supported by high-level evidence. Future perspectives and promising advances in drug development are discussed and areas of improvement are identified in order to promote better cancer control and decrease the rate and severity of side-effects.
Texto completo:
Disponible
Índice:
LILACS (Américas)
Asunto principal:
Neoplasias de la Vejiga Urinaria
/
Vacuna BCG
/
Adyuvantes Inmunológicos
/
Inmunoterapia
/
Antineoplásicos
Tipo de estudio:
Guía de Práctica Clínica
/
Estudio pronóstico
Límite:
Humanos
Idioma:
Inglés
Revista:
Int. braz. j. urol
Asunto de la revista:
Urología
Año:
2009
Tipo del documento:
Artículo
País de afiliación:
Estados Unidos
Institución/País de afiliación:
Sloan-Kettering Institute/US
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