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Emerging therapies in the management of high-risk non-muscle invasive bladder cancer (HRNMIBC)

  • Ryan P. Werntz
  • Brittany Adamic
  • Gary D. Steinberg
Topic Paper

Abstract

Purpose

BCG is the gold standard in management of high-risk non-muscle invasive bladder cancer (HRNMIBC). However, in patients who fail BCG, there are few effective intrasvesical options. This review aims to explore standard and emerging therapies in HRNMIBC.

Methods

A non-systematic literature review was performed using Medline and PubMed. Literature focused on HRNMIBC and BCG failure studies, with particular attention to Phase II and III clinical trials.

Results

The only FDA approved therapy for BCG failure patients in Valrubicin. Patients with HRNMIBC and BCG failure patients are at increased risk for progression and death from bladder cancer. There are a variety of clinical trials exploring different therapeutic approaches such as immunotherapy, vaccines, radiotherapy, and gene therapy. These trials are showing some promise in the early reporting phase.

Conclusion

Despite limited intravesical treatment options in BCG failure patients, there are several promising therapies currently being developed and several with promising early results.

Keywords

Non-muscle invasive bladder cancer BCG failure Immunotherapy Vaccines 

Notes

Author contributions

RW: Protocol/project development-yes, data collection or management-yes, data analysis-N/A, manuscript writing/editing-writing and editing. BA, M.D.: Protocol/project development-yes, data collection or management-yes, data analysis-N/A, manuscript writing/editing-writing and editing. GDS, M.D.: Protocol/project development-yes, data collection or management-no, data analysis-N/A, manuscript writing/editing-editing.

Compliance with ethical standards

Conflict of interest

Gary Steinberg: I am a scientific advisor/consultant for the following companies: Heat Biologics, Cold Genesys, PhotoCure, Merck, Roche/Genentech, Taris Biomedical, MDxHealth, Fidia Farmaceuticals, Urogen, Spectrum Pharmaceuticals, Biocancell, Epivax Oncology, Natera, FKD, Synergo, BMS, Boston Scientific, Ferring Pharmaceuticals, QED. Ryan Werntz: none. Brittany Adamic: none.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Ryan P. Werntz
    • 1
  • Brittany Adamic
    • 1
  • Gary D. Steinberg
    • 1
  1. 1.Section of Urology, Department of SurgeryThe University of Chicago Medicine, ChicagoChicagoUSA

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