肌层浸润性膀胱癌免疫治疗进展

Advances in Immunotherapy for Muscle-Invasive Bladder Cancer

摘要: 肌层浸润性膀胱癌作为泌尿系统侵袭性最强的恶性肿瘤之一，传统的根治性膀胱切除术存在着创伤大、并发症多、患者生活质量下降等不足。近年来，以各类免疫检查点抑制剂，如程序性死亡受体1/程序性死亡受体配体1抑制剂为核心的围手术期免疫治疗策略显著改善了患者预后，治疗前景迎来了前所未有的拓展，免疫治疗逐渐展示出令人振奋的效果。有关基层浸润性膀胱癌的临床研究显示，免疫治疗不仅在晚期膀胱癌中是一种更安全、潜在有效的治疗选择，而且在疾病早期的治疗中也表现出良好的疗效。本文就肌层浸润性膀胱癌相关免疫治疗方面的进展及替雷利珠等免疫抑制剂在肌层浸润性膀胱癌中的应用展开综述。

Abstract: Muscle-invasive bladder cancer (MIBC) is one of the most aggressive malignancies in the urological system, is traditionally managed with radical cystectomy. However, this approach is associated with high morbidity, significant complications, and compromised quality of life. In recent years, perioperative immunotherapy strategies centered on immune checkpoint inhibitors (ICIs), particularly programmed death-1/programmed death-ligand 1 (PD-1/PD-L1) inhibitors, have markedly improved patient prognosis, and the therapeutic landscape has undergone unprecedented expansion. Emerging clinical trials demonstrate that immunotherapy not only serves as a safer and potentially effective option for advanced bladder cancer but also exhibits promising efficacy in early-stage disease. This article provides a comprehensive review of recent advances in immunotherapy for MIBC, with a focus on the clinical applications of immune checkpoint inhibitors, particularly PD-1 inhibitors such as tislelizumab, in the management of this disease.