Revolutionizing Treatment: Breakthrough Approaches for BCG-Unresponsive Non-Muscle-Invasive Bladder Cancer

Abstract

Bladder cancer is the 10th most popular cancer in the world, and non-muscle-invasive bladder cancer (NMIBC) is diagnosed in ~80% of all cases. Treatments for NMIBC include transurethral resection of the bladder tumor (TURBT) and intravesical instillations of Bacillus Calmette-Guérin (BCG). Treatment of BCG-unresponsive tumors is scarce and usually leads to Radical Cystectomy. In this paper, we review recent advancements in conservative treatment of BCG-unresponsive tumors. The main focus of the paper is FDA-approved medications: Pembrolizumab and Nadofaragene Firadenovec (Adstiladrin). Other, less researched therapeutic possibilities are also included, namely: N-803 immunotherapy, TAR-200 and TAR-210 intravesical delivery systems and combined Cabazitaxel, Gemcitabine and Cisplatin chemotherapy. Conservative treatment and delaying radical cystectomy would greatly benefit patients’ quality of life; it is undoubtedly the future of BCG-unresponsive NMIBC.

Liquid foam improves potency and safety of gene therapy vectors

“…Thus, we anticipate our gene therapy strategy could be swiftly adopted into clinical practice to address critical gaps that limit the application of gene therapy: The problem of practicality: As far as we know, there are currently no methods in the clinic that allow the delivery of gene therapy vectors to specific target cells in tissue. FDA-approved in situ gene therapies either expose the patient to vector systemically (e.g., Elevidys® for Duchenne Muscular Dystrophy 25 ) or inject vector directly into a confined space, such as the bladder (Adstiladrin® 26 ), the spinal canal (Qalsody® for amyotrophic lateral sclerosis 27 ) or the eyeball (Luxturna® for retinal disease 28 ). In the latter three treatments, the vector has little opportunity to leak and thus is able to unload its DNA cargo into a maximum number of target cells.…”