Emerging Immunotherapy Options for BCG-unresponsive Non-muscle-invasive Bladder Cancer.

Abstract

PURPOSE\nDue to the high rate of recurrence and progression in patients with high-risk non-muscle-invasive bladder cancer (NMIBC), there exists an important unmet need to identify new therapies. This is especially the case for patients recurring after optimal intravesical bacillus Calmette-Guérin (BCG), who are classified as having BCG-unresponsive disease.\n\n\nMATERIALS AND METHODS\nThe PubMed® database was searched for publications related to immunotherapy for the treatment of patients with NMIBC who have recurrent or progressive disease despite intravesical BCG therapy. Relevant congress abstracts were identified through searches of individual congress websites. Relevant planned and ongoing studies were identified via ClinicalTrials.gov or associated web searches.\n\n\nRESULTS\nWe provide a summary of the currently available immunotherapy options for patients with BCG-unresponsive NMIBC and discuss planned and ongoing research of potential targeted agents and immunotherapy-based combination regimens.\n\n\nCONCLUSIONS\nThere is a clear biological and clinical rationale for the continued evaluation of immune-based therapies in the setting of BCG-unresponsive NMIBC. Data from early-phase trials with novel immunotherapies targeting multiple immune-related pathways have emerged, which support additional studies to assess the benefits of immune checkpoint inhibitors and other immunotherapy-based regimens for patients with BCG-unresponsive NMIBC.