Endoscopic Molecular Imaging plus Photoimmunotherapy: A New Strategy for Monitoring and Treatment of Bladder Cancer

Abstract

Due to the high recurrence and progression rate of non-muscle invasive bladder cancer after transurethral resection of bladder tumor, some new optical imaging technologies have arisen as auxiliary imaging modes for white light cystoscopy to improve the detection rate of small or occult tumor lesions, such as photodynamic diagnosis, narrow-band imaging, and molecular imaging. White light cystoscopy is inadequate and imperfect for bladder cancer detection, and thus residual tumors or coexisting flat malignant lesions, especially carcinoma in situ , would be ignored during conventional resection. The bladder, a hollow organ with high compliance, provides an ideal closed operation darkroom for endoscopic molecular imaging free from interference of external light sources. Also, intravesical instillation of a molecular fluorescent tracer is simple and convenient before surgery through the urethra. Molecular fluorescent tracer has high sensitivity and specificity to tumor cells, and its mediated molecular imaging allows small or occult tumor lesion detection while minimizing false-positive results. Meanwhile, endoscopic molecular imaging provides a real-time and dynamic image during surgery, which helps urologists to perform high-quality and complete tumor resection through accurate judgment of tumor boundaries and depth of invasion. Photoimmunotherapy is a novel molecular targeted therapeutic pattern of photodynamic therapy that kills malignant cells selectively and minimizes the cytotoxicity to normal tissues. The combination of endoscopic molecular imaging and photoimmunotherapy used in initial treatment may avoid the need of repeat transurethral resection in strictly selected patients and improve oncological outcomes such as recurrence-free survival and overall survival after operation.

Development of Photoremovable Linkers as a Novel Strategy to Improve the Pharmacokinetics of Drug Conjugates and Their Potential Application in Antibody–Drug Conjugates for Cancer Therapy

“…The enhanced permeability and retention (EPR) in the tumor vessels and the impaired cellular membrane function by aggregation and solubility changes cause immediate necrosis. On the other hand, the targeted cell death can be induced by immunogenic actions such as rapid maturation of dendritic cells and priming of cancer-specific cytotoxic T cells from cancer-specific antigens, which are released into the tumor microenvironment on photoactivation of NIR-PIT [99][100][101].…”

“…The enhanced permeability and retention (EPR) in the tumor vessels and the impaired cellular membrane function by aggregation and solubility changes might cause immediate necrosis. On the other hand, the targeted cell death can be induced by immunogenic actions such as rapid maturation of dendritic cells and priming of cancer-specific cytotoxic T cells from cancer-specific antigens, which are released into the tumor microenvironment photoactivation of NIR-PIT [99][100][101]. NIR-PIT selectively destroys cancer cells, leading to immunogenic cell death that initiates special local features of near-infrared laser light used in the therapy, such as good tissue penetration, nonthermal and not ionizing radiation; thus, there is no damage to cellular DNA, making NIR-PIT selective for the treatment of superficial tumors and tumors in the lung and pleural cavity with good control of off-target effects.…”

FUT7 Promotes the Epithelial–Mesenchymal Transition and Immune Infiltration in Bladder Urothelial Carcinoma

“…7,8 Despite the improvements in multimode therapeutics and surgical techniques, the 5-year survival rate for BLCA patients has not been promoted significantly due to the lack of sensitive biomarkers, obvious clinical symptoms at the early stage and high recurrence rate. [9][10][11] Therefore, it is imperative to explore the underlying mechanism responsible for cancer progression, as well as novel effective biomarkers for the diagnosis and prognosis prediction, and also therapeutic targets for BLCA to ameliorate patients' survival rate.…”

RalGPS2 Interacts with Akt and PDK1 Promoting Tunneling Nanotubes Formation in Bladder Cancer and Kidney Cells Microenvironment

“…In particular, the cost of therapies for bladder cancer is the highest, compared to other cancers in the United States [ 5 , 6 ] and Europe, and has a huge impact on public health costs [ 7 ].…”