Current intravesical therapies BCG-failure in non-muscle-invasive bladder cancer

Abstract

The first-line treatment for non-muscle invasive bladder cancer (NMIBC) is intravesical Bacillus CalmetteGuerin (BCG). Despite BCG, alternative treatments are urgently required for recurrent or progressive bladder cancer. Cystectomy is the gold standard treatment in BCG failure in bladder cancer. When cystectomy can not be performed for reasons related to the patient, other treatments should be started. Many clinical studies such as intravesical gemcitabine, taxanes or combination treatment, new therapeutic agents,..etc are critical in determining the next step. Alternative to radical cystectomy, well designed and many new treatment studies are still ongoing. They seem ready for routine clinical practice in the near future. We believe that NMIBC treatment modalities will change in the near future.

Keywords

• Non-muscle invasive bladder cancer
• BCG-refractory
• Radical cystectomy
• intravesical teratments

Kasa invaze olmayan BCG-refraktör mesane kanserinde güncel tedaviler

Abstract

Kasa invaziv olmayan mesane kanseri (KİOMK) için birinci basamak tedavi intravezikal Bacillus Calmette-Guerin’dir (BCG). BCG’ye rağmen, tekrarlayan veya ilerleyen mesane kanseri için acilen alternatif tedavilere ihtiyaç vardır. BCG-refraktör Mesane kanserinde radikal sistektomi altın standart tedavidir. Hastaya bağlı nedenler ile(komorbidite, operasyon istememe gibi) sistektomi yapılamadığında diğer tedavilere başlanmalıdır. İntravezikal gemstabin, taksanlar, kombinasyon tedavileri , aşılar, gen terapisi gibi birçok klinik çalışma, bir sonraki adımı belirlemede kritik öneme sahiptir. Radikal sistektomiye alternatif, iyi tasarlanmış birçok yeni tedavi çalışması halen devam etmektedir. Yakın gelecekte rutin klinik uygulamaya girmesi beklenmektedir. Yeni tedaviler ile beraber mesane kanser tedavisinde önemli değişiklikler olacaktır.

Keywords

• Kasa İnvaze olmayan mesane kanseri
• BCG-Refraktör
• Radikal sistektomi
• intravezikal tedaviler

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