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首页> 外文期刊>Nature reviews. Urology >Optimizing pharmacokinetics of intravesical chemotherapy for bladder cancer
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Optimizing pharmacokinetics of intravesical chemotherapy for bladder cancer

机译：优化膀胱癌膀胱学化疗的药代动力学

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Non-muscle-invasive bladder cancer (NMIBC) remains one of the most common malignancies and is associated with considerable treatment costs. Patients with intermediate-risk or high-risk disease can be treated with intravesical BCG, but many of these patients will experience tumour recurrence, despite adequate treatment. Standard of care in these patients is radical cystectomy with urinary diversion, but this approach is associated with considerable morbidity and lifestyle modification. As an alternative, perioperative intravesical chemotherapy is recommended for low-risk papillary NMIBC, and induction intravesical chemotherapy is an option for patients with intermediate-risk NMIBC and BCG-unresponsive NMIBC. However, poor pharmaceutical absorption and drug washout during normal voiding can limit sustained drug concentrations in the urothelium, which reduces efficacy, and small-molecule chemotherapeutic agents can be absorbed through the urothelium into the bloodstream, leading to systemic adverse effects. Several novel drug delivery methods - including hyperthermia, mechanical sustained released devices and nanoparticle drug conjugation - have been developed to overcome these limitations. These novel methods have the potential to be combined with established chemotherapeutic agents to change the paradigm of NMIBC treatment.
机译：非肌肉侵入性膀胱癌（NMIBC）仍然是最常见的恶性肿瘤之一，并且与相当大的治疗成本有关。患有中性风险或高风险疾病的患者可以用膀胱内的BCG治疗，但尽管治疗足够，但这些患者的许多患者将会经历肿瘤复发。这些患者的护理标准是尿液引入的激进膀胱切除术，但这种方法与相当大的发病率和生活方式改性有关。作为替代方案，推荐用于低风险乳头状NMIBC的围手术期膀胱内化疗，并且诱导膀胱内化疗是患有中间风险NMIBC和BCG无响应NMIBC患者的选择。然而，在正常空隙期间的药物吸收和药物冲洗差可以限制尿浆中持续的药物浓度，这降低了功效，并且小分子化学治疗剂可以通过尿素吸收到血液中，导致系统性不利影响。已经开发出几种新型药物递送方法 - 包括热疗，机械持续释放的装置和纳米粒子药物缀合 - 以克服这些限制。这些新方法具有与已建立的化学治疗剂结合以改变NMIBC治疗的范例。

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