Current Clinical Trials in Non-muscle-Invasive Bladder Cancer: Heightened Need in an Era of Chronic BCG Shortage.

Abstract

PURPOSE OF REVIEW:

BCG is the gold standard agent used in high-risk non-muscle-invasive bladder cancer (NMIBC) that is amenable to bladder sparing management. However, recent BCG shortages appear to be a chronic problem. There are limited effective intravesical options in lieu of BCG or in patients in whom BCG is not effective. This review aims to highlight emerging bladder sparing therapies and trials for NMIBC.

RECENT FINDINGS:

Patients with high-risk NMIBC who do not respond to BCG are at increased risk for progression and death from bladder cancer. There are a variety of clinical trials exploring different therapeutic approaches including checkpoint inhibition, novel chemotherapy and drug delivery, viral and gene therapy, vaccines, and targeted therapy. In the era of limited supply of BCG, there is a need for both effective first-line alternatives as and options for patients who do not respond to BCG. Fortunately, there are a variety of active trials and mechanisms exploring these areas aggressively.

• Authors: Vignesh T Packiam, Ryan P Werntz, Gary D Steinberg
• Journal: Current urology reports (Curr Urol Rep) Vol. 20 Issue 12 Pg. 84 (Nov 28 2019) ISSN: 1534-6285 [Electronic] United States
• PMID: 31781942 (Publication Type: Journal Article, Review)

Chemical References

• Antibodies, Monoclonal
• Antineoplastic Agents
• Antineoplastic Agents, Immunological
• BCG Vaccine
• Cancer Vaccines

Topics

• Administration, Intravesical
• Antibodies, Monoclonal (therapeutic use)
• Antineoplastic Agents (therapeutic use)
• Antineoplastic Agents, Immunological (therapeutic use)
• BCG Vaccine (administration & dosage, supply & distribution)
• Cancer Vaccines (therapeutic use)
• Cell Cycle Checkpoints (drug effects)
• Clinical Trials as Topic
• Disease Progression
• Genetic Therapy
• Humans
• Immunotherapy (methods)
• Oncolytic Virotherapy
• Urinary Bladder Neoplasms (pathology, therapy)