scholarly journals Bladder-Sparing Chemoradiotherapy Combined with Immune Checkpoint Inhibition for Locally Advanced Urothelial Bladder Cancer—A Review

Cancers ◽  
2021 ◽  
Vol 14 (1) ◽  
pp. 38
Author(s):  
Jons W. van Hattum ◽  
Ben-Max de Ruiter ◽  
Jorg R. Oddens ◽  
Maarten C. C. M. Hulshof ◽  
Theo M. de Reijke ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Survival Data ◽  
Immune Checkpoint ◽  
Checkpoint Inhibitors ◽  
Locally Advanced ◽  
Treatment Strategies ◽  
Current Treatment ◽  
Term Survival ◽  
First Choice ◽  
Bladder Sparing

Despite current treatment strategies, the 5-year overall survival of muscle-invasive bladder cancer (MIBC) is approximately 50%. Historically, radical cystectomy (RC) with neoadjuvant chemotherapy has been the first-choice treatment for this patient group. Recently, several studies have reported encouraging results of using immune checkpoint inhibitors (ICI) prior to RC. However, in recent years, bladder-sparing alternatives such as CRT have gained popularity. The effect of radiotherapy on the tumor microenvironment is an important rationale for combining CRT with ICI therapy. Worldwide, twelve immunochemoradiotherapy (iCRT) trials are ongoing. Each study employs a different chemotherapy and radiotherapy regimen and varies the timing of ICI administration concurrent to radiotherapy, adjuvant, or both. Five studies have presented (preliminary) results showing promising safety and short-term survival data. The first peer-reviewed publications are expected in the near future. The preclinical evidence and preliminary patient data demonstrate the potential of iCRT bladder-sparing treatment for bladder cancer.

scholarly journals Mechanisms of Immune Checkpoint Inhibitor-Mediated Colitis

2021 ◽  
Vol 12 ◽  
Author(s):  
Harm Westdorp ◽  
Mark W. D. Sweep ◽  
Mark A. J. Gorris ◽  
Frank Hoentjen ◽  
Marye J. Boers-Sonderen ◽  
...  
Keyword(s):  
Immune Cells ◽  
Immune Checkpoint ◽  
Checkpoint Inhibitors ◽  
Treatment Strategies ◽  
Human Colon ◽  
Current Treatment ◽  
T Cell Subsets ◽  
Cellular Mechanisms ◽  
Patients At Risk ◽  
The One

Immune checkpoint inhibitors (ICIs) have provided tremendous clinical benefit in several cancer types. However, systemic activation of the immune system also leads to several immune-related adverse events. Of these, ICI-mediated colitis (IMC) occurs frequently and is the one with the highest absolute fatality. To improve current treatment strategies, it is important to understand the cellular mechanisms that induce this form of colitis. In this review, we discuss important pathways that are altered in IMC in mouse models and in human colon biopsy samples. This reveals a complex interplay between several types of immune cells and the gut microbiome. In addition to a mechanistic understanding, patients at risk should be identifiable before ICI therapy. Here we propose to focus on T-cell subsets that interact with bacteria after inducing epithelial damage. Especially, intestinal resident immune cells are of interest. This may lead to a better understanding of IMC and provides opportunities for prevention and management.

scholarly journals Focus on Biochemical and Clinical Predictors of Response to Immune Checkpoint Inhibitors in Metastatic Urothelial Carcinoma: Where Do We Stand?

2020 ◽  
Vol 21 (21) ◽  
pp. 7935 ◽  
Author(s):  
Giandomenico Roviello ◽  
Martina Catalano ◽  
Stefania Nobili ◽  
Raffaella Santi ◽  
Enrico Mini ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitors ◽  
Checkpoint Inhibitors ◽  
Locally Advanced ◽  
The United States ◽  
Variable Response ◽  
Clinical Predictors ◽  
Metastatic Urothelial Cancer ◽  
Platinum Based Chemotherapy

Urothelial bladder cancer is one of the most lethal cancers worldwide with barely 5% five-year survival in patients with metastatic disease. Intravesical immunotherapy with Bacillus Calmette-Guérin and platinum-based chemotherapy are currently the standard of care for non-muscle invasive and advanced or metastatic urothelial cancer (mUC), respectively. Recently, a subset of patients with locally advanced or mUC has shown to be responsive to immune checkpoint inhibitors (ICIs), e.g., the anti-cytotoxic T-lymphocyte-associated protein 4 and programmed cell death -1/programmed death-ligand1 (PD-1/PD-L1) antibodies. Due to the relevant clinical benefit of immunotherapy for mUC, in 2016, the United States Food and Drug Administration (FDA) approved five immunotherapeutic agents as second-line or first-line treatments for patients with advanced bladder cancer who did not profit from or were ineligible for standard therapy. In this review, we discuss the role of immunotherapy in bladder cancer and recent clinical applications of PD-1/PD-L1 blockade in mUC. Furthermore, we evaluate a variable response rate to ICIs treatment and outline potential biomarkers predictive of immunotherapy response.

Role of immunotherapy in oligometastatic nonsmall cell lung cancer

2021 ◽  
Vol 14 (5) ◽  
pp. e241070
Author(s):  
Yehuda Galili ◽  
Ahmad El-Far ◽  
Jennifer Tseng ◽  
Steve Carlan
Keyword(s):  
Lung Cancer ◽  
Cell Lung Cancer ◽  
Immune Checkpoint ◽  
Checkpoint Inhibitors ◽  
Treatment Strategies ◽  
Nonsmall Cell Lung Cancer ◽  
Current Treatment ◽  
Adjunctive Treatment ◽  
Comfort Care ◽  
Metastatic Lung

The approach to metastatic lung cancer has long been focused on palliation therapy and comfort care. Recently, significant subsets of patients who suffer from a limited form of the disease have shown curative outcomes. The oligometastatic disease theory was first introduced in 1995, and since has been applied to many solid tumours. In oligometastatic nonsmall cell lung cancer, current treatment strategies include surgery, radiation therapy and chemotherapy. There is evidence of astounding survival benefits in selected patients treated with immune checkpoint inhibitors. We present three cases with oligometastatic nonsmall cell lung cancer treated with pembrolizumab, an immune checkpoint inhibitor, and describe the outcomes. Immunotherapy with pembrolizumab appears to be an effective adjunctive treatment with low toxicity in oligometastatic nonsmall cell lung cancer.

scholarly journals Immune Checkpoint Inhibitors in Urothelial Bladder Cancer: State of the Art and Future Perspectives

Cancers ◽  
2021 ◽  
Vol 13 (17) ◽  
pp. 4411
Author(s):  
Giandomenico Roviello ◽  
Martina Catalano ◽  
Raffaella Santi ◽  
Valeria Emma Palmieri ◽  
Gianmarco Vannini ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitors ◽  
Checkpoint Inhibitors ◽  
Early Stage ◽  
Locally Advanced ◽  
High Morbidity ◽  
Future Perspectives ◽  
Urothelial Bladder ◽  
Muscle Invasive

Bladder cancer (BC) is the most common malignancy of the genitourinary tract, with high morbidity and mortality rates. Until recently, the treatment of locally advanced or metastatic urothelial BC was based on the use of chemotherapy alone. Since 2016, five immune checkpoint inhibitors (ICIs) have been approved by the Food and Drug Administration (FDA) in different settings, i.e., first-line, maintenance and second-line treatment, while several trials are still ongoing in the perioperative context. Lately, pembrolizumab, a programmed death-1 (PD-1) inhibitor, has been approved for Bacillus Calmette–Guérin (BCG)-unresponsive high-risk non-muscle invasive bladder cancer (NMIBC), using immunotherapy at an early stage of the disease. This review investigates the current state and future perspectives of immunotherapy in BC, focusing on the rationale and results of combining immunotherapy with other therapeutic strategies.

Sign in / Sign up

Export Citation Format

Share Document