肿瘤细胞治疗研究
英文原题：Advances in the immunological microenvironment and immunotherapy of bladder cancer.
这些免疫治疗进展正在改变膀胱癌的管理，在改善结局的同时降低治疗相关并发症。
膀胱癌仍是全球重大健康挑战，男性尤为多见。根治性膀胱切除和化疗一直是主要治疗方法，但其显著发病负担和对生活质量的影响推动了保留膀胱的免疫治疗策略发展。临床试验数据支持在不适合顺铂治疗患者中将免疫检查点抑制剂（ICI）作为一线治疗，在铂类耐药疾病中作为二线治疗，以及作为维持治疗。本综述全面总结膀胱癌免疫治疗进展，重点讨论肿瘤免疫微环境和新兴治疗方式，并介绍靶向PD-1/PD-L1及CTLA-4通路的免疫检查点抑制剂（ICI）；这些疗法在肌层浸润性膀胱癌（MIBC）和非肌层浸润性膀胱癌（NMIBC）中均显示出显著疗效。本文还介绍联合免疫治疗、肿瘤疫苗、过继细胞疗法及溶瘤病毒等新策略。总体而言，这些免疫治疗进展正在改变膀胱癌管理方式，既改善患者结局，也减少治疗相关发病负担。
Bladder cancer remains a significant global health challenge, particularly affecting male populations. While radical cystectomy and chemotherapy have been mainstays of treatment, their substantial morbidity and impact on quality of life have driven the development of bladder-preserving immunotherapeutic strategies. Clinical trial data support the use of ICIs as first-line therapy for cisplatin-ineligible patients, second-line treatment for platinum-refractory disease, and maintenance therapy. This review comprehensively summarizes the advances in bladder cancer immunotherapy, focusing on the tumor immune microenvironment and emerging treatment modalities, as well as the roles of immune checkpoint inhibitors (ICIs) targeting PD-1/PD-L1 and CTLA-4 pathways, which have demonstrated remarkable efficacy in both muscle-invasive (MIBC) and non-muscle invasive bladder cancer (NMIBC). This review also provides novel approaches including combination immunotherapies, tumor vaccines, adoptive cellular therapies, and oncolytic viruses. Overall, these immunotherapeutic advances are transforming bladder cancer management, offering improved outcomes while reducing treatment morbidity.
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