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首页> 外文期刊>Nature reviews. Urology >Incontinence: liposomal onabotulinumtoxinA instillation piloted for OAB.
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Incontinence: liposomal onabotulinumtoxinA instillation piloted for OAB.

机译：尿失禁：试用于OAB的脂质体载脂蛋白毒素A滴注。

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Nearly three-quarters of all newly diagnosed urothelial cancers are non-muscle-invasive bladder cancers (NMIBCs). Although bladder-preserving surgery can be used to treat NMIBC, the rate of recurrence remains high. Intravesical chemotherapy has been shown to reduce the rate of NMIBC recurrence, and mitomycin C (MMC) has become the most commonly used intravesical cytotoxic agent. Despite the popularity of this agent in the treatment of NMIBCs, many questions regarding the optimal approach to MMC therapy remain unanswered. Strategies to enhance delivery of MMC have been well studied and multiple measures are recommended for implementation in routine clinical practice. In addition, less widely investigated techniques, such as hyperthermia and electromotive drug administration, have been shown to increase the efficacy of MMC therapy. Nevertheless, even when the current 'optimal' approaches to MMC administration are used, a large proportion of NMIBCs recur. This apparent treatment resistance might be overcome by combination of MMC with other agents that have different mechanisms of action and are unlikely to have cross-resistance. Study of the mechanisms of resistance is, therefore, important to identify key pathways underlying this phenomenon, which could be rationally targeted using specific combinations of drugs. Knowledge of these mechanisms might also reveal markers of responsiveness to therapy that could be used for patient selection.
机译：在所有新诊断的尿路上皮癌中，近四分之三是非肌肉浸润性膀胱癌（NMIBC）。尽管保留膀胱的手术可用于治疗NMIBC，但复发率仍然很高。膀胱内化疗已显示可降低NMIBC复发率，丝裂霉素C（MMC）已成为最常用的膀胱内细胞毒剂。尽管这种药物在NMIBC的治疗中很受欢迎，但有关MMC治疗最佳方法的许多问题仍未得到解答。已经对提高MMC递送的策略进行了深入研究，并建议在常规临床实践中采取多种措施。另外，还没有得到广泛研究的技术，例如热疗和电动药物管理，可以提高MMC治疗的疗效。但是，即使使用当前的MMC管理“最佳”方法，也会发生很大一部分NMIBC。 MMC与其他具有不同作用机制且不太可能具有交叉耐药性的药物联合使用可以克服这种明显的治疗耐药性。因此，对耐药机制的研究对于确定这种现象的关键途径很重要，可以使用特定的药物组合合理地靶向该现象。这些机制的知识也可能会揭示对治疗反应的标记，可以用于患者选择。

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