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[BCG Immunotherapy, past, present and future.]

Abstract：

:Since its introduction more than 40 years ago, adjuvant treatment with BCG (Bacillus Calmette-Guérin) for non-muscle invasive bladder cancer (NMIBC) continues to be the treatment recommended in the highrisk group, and one of the most successful immunotherapies for cancer treatment. However, up to 20% of patients will progress to muscle-invasive disease after BCG treatment. On the other hand, we are facing a shortage of BCG supply worldwide. Despite its extensive clinical use, there is no clear certainty of the mechanism of action of BCG, and controversy persists regarding to the most effective dose and strains, as well as their usefulness in combined treatments with other drugs and with devices that could facilitate their action on the bladder. This article historically reviews the impact that has had BCG in the treatment of NMIBC, the current guidelines in terms of doses, strains and treatments combination, and the future that will happen with the results of the ongoing clinical trials with systemic immunotherapy, vaccines and gene therapy. :Desde su introducción hace más de 40 años, el tratamiento adyuvante con BCG (Bacilo Calmette-Guérin) para el tumor vesical no-músculo invasivo (TVNMI) sigue siendo el tratamiento de elección en el grupo de alto riesgo, y una de las inmunoterapias para el cáncer de mayor éxito. Sin embargo, hasta el 20% de los pacientes progresarán a enfermedad músculo-invasiv adespués del tratamiento con BCG. Por otra parte,nos encontramos ante una escasez de suministro de BCG a nivel mundial. A pesar de su extenso uso clínico, no existe una clara certeza del mecanismo de acción de la BCG, y todavía persiste controversia en cuanto a las dosis y cepas más eficaces, así como su utilidad en tratamientos combinados con otros fármacos y con dispositivos que podrían facilitan su acción en la vejiga. En este artículo se revisa históricamente el impacto que ha tenido la BCG en el tratamiento del TVNMI, las directrices actuales en cuanto a dosis, cepas y tratamientos de combinación, y el futuro que acontecerá con los resultados de los ensayos clínicos sobre inmunoterapia sistémica, inmuno moduladores, vacunas y terapia génicaen el TVNMI.

journal_name

Arch Esp Urol

journal_title

Archivos espanoles de urologia

authors

Rodríguez Faba Ó,Huguet Pérez J,Pisano F,Parada R,Palou J,Breda A

subject

Has Abstract

pub_date

2020-12-01 00:00:00

pages

918-928

issue

10

eissn

0004-0614

issn

1576-8260

pii

2021-73-10-99a5a6d28f93ee9dba66ce18310d6b50a714ad0

journal_volume

73

pub_type

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