Up-to-date strategies in the treatment of non-muscle invasive bladder cancer

Non-muscle-invasive bladder cancer (NMIBC) is a prominent form of urinary bladder malignancy, necessitating ongoing and innovative treatment strategies to enhance patient outcomes. Recent advances have primarily focused on improving the efficacy of intravesical therapies, which are administered directly into the bladder. One significant innovation is the use of immune checkpoint inhibitors, which have shown promising results in a subset of patients with NMIBC who have not responded adequately to conventional therapy. The introduction of agents like Atezolizumab and Nivolumab has been pivotal, targeting the PD-L1 pathway and thereby rekindling the body’s immune response to cancerous cells. Furthermore, the advent of novel formulations of Bacillus Calmette-Guérin (BCG), such as intravesical therapies that combine multiple agents or utilize sustained-release mechanisms, has demonstrated enhanced efficacy while aiming to reduce side effects. This is vital since BCG is the historical cornerstone of NMIBC treatment, and its effectiveness has been hampered by decreased availability and varying therapeutic responses due to resistance. Additionally, new biomarkers are being researched to identify patients who are more likely to benefit from specific treatments or to predict progression toward muscle-invasive disease. This stratification could significantly optimize treatment pathways and support personalized medicine approaches. Advances in technology, such as photodynamic therapy and microwave hyperthermia, also hold potential in augmenting conventional treatment, demonstrating a commitment to an expanding arsenal against this prevalent disease. Overall, recent innovations in NMIBC treatment are poised to offer patients improved outcomes, reducing recurrence rates and enhancing the quality of life.
Keywords: bladder cancer, biomarkers, BCG, therapy, innovations