Current clinical trials in non–muscle invasive bladder cancer

Abstract

Background The treatment options for non-muscle invasive bladder cancer (NMIBC) remain limited. BCG was the last major breakthrough in bladder cancer therapy almost 4 decades ago. There have been improvements in the understanding of immune therapies and cancer biology, leading to the development of novel agents. This has led to many clinical trials that are currently underway to find the next generation of therapies for NMIBC. Method We reviewed clinicaltrials.org and pubmed.gov to find the recently completed and ongoing clinical trials in NIMBC. Included in this review are clinical trials that are currently active and trials that were completed in and after 2014. Result Many trials with BCG naïve and BCG unresponsive/recurrent/refractory/failure NMIBC patients are either currently underway or have been recently completed. A wide variety of novel therapeutic agents are being investigated that range from cytotoxic agents to immunomodulatory agents to targeted molecular therapies. Other approaches include cancer vaccines, gene therapies, and chemoradiation potentiation agents. Novel drug delivery methods are also being tested. Conclusion This comprehensive update of current trials provides researchers an overview of the current clinical trial landscape for patients with NMIBC.

Alternative therapies in patients with non-muscle invasive bladder cancer

“…Accordingly, despite considerable effort with the idea of overcoming drug resistance with combinations of drugs, currently no intravesical drug combination is widely utilized. [31] Others Keyhole limpet hyocyanin (KLH) is a strong humoral and cellular immune-stimulant in both experimental animal models and humans. It is filtered from hemolymph of Megathura cranulata, also called the giant keyhole limpet, a native sea creature in Southern Carolina and Mexico.…”

New therapies in nonmuscle invasive bladder cancer treatment

“…[ 32 ] Other monoclonal antibodies targeting the interaction between PD-1 and PD-L1 include pembrolizumab and atezolizumab and are being evaluated in several ongoing trials. [ 38 ] These trials are evaluating the PD-1/PD-L1 inhibitors in BCG-unresponsive disease either as single agents or in combination with BCG. One new novel trial being performed at the National Cancer Institute (NCI) will treat patients with combination immunotherapy consisting of an intravesical fusion protein (Vicinium) with systemic checkpoint PD-L1 inhibition (Durvalumab).…”

“…However, to date, no data have been published demonstrating the clinical efficacy of monoclonal antibodies as checkpoint inhibitors in NMIBC. [ 27 38 ]…”

“…Recent and ongoing clinical trials are exploring the efficacy of vaccine treatment in the setting of BCG naïve patients (recMAGE-A3 and CAVATAK), BCG unresponsive patients (ALT-801 and PANVAC), or both (HS-410). [ 38 ]…”

Bacillus Calmette–Guérin strain differences as the basis for immunotherapies against bladder cancer

“…69,70 Many trials with BCG-na€ ıve and BCG-unresponsive/recurrent/refractory/failure patients with NMIBC are also underway. 72 atezolizumab) have proven to be effective in metastatic bladder cancer, and there is optimism regarding their roles in the NMIBC setting.…”