Neoadjuvant immunotherapy driven bladder preservation for muscle invasive bladder cancer

作者：Jiao Hu, Luzhe Yan, Jinhui Liu, Minfeng Chen, Yunbo He, Benyi Fan, Bo Peng, Long Wang, Weibin Hou, Chao Li, Bosen You, Meng Zhang, Wenze Li, Jiaxing Wang, Hongzhou Cai, Shenglin Gao, Yang Liu, Dingshan Deng, Huihuang Li, Guanghui Gong, Jiansheng Tang, Chengyong Wang, Xiaofeng Yang, Liang Wei, Guangzheng Lin, Ruizhe Wang, Xiao Guan, Shiyu Tong, Yangle Li, Wei He, Zhiyong Cai, Peihua Liu, Yu Gan, Yu Cui, Yuanqing Dai, Yi Cai, Zefu Liu, Jiatong Xiao, Zhenyu Nie, Zhenyu Ou, Jinbo Chen, Xi Guo, Xiongbing Zu · 发表于：iMeta · 年份：2025 · DOI：10.1002/imt2.70063 · 被引用次数：3 · 研究领域：Bladder and Urothelial Cancer Treatments、Urinary and Genital Oncology Studies、Tea Polyphenols and Effects

The standard treatment for muscle-invasive bladder cancer (MIBC) is radical cystectomy (RC) following neoadjuvant treatment. Patients lose their bladders and their functions after RC [1, 2], and urine is drained through a stoma bag on the abdominal wall, which severely impacts their quality of daily life and mental health. With the advancement of multidisciplinary treatment and the pursuit of a higher quality of life for patients, the treatment schedule for localized MIBC has gradually shifted from RC to comprehensive modes, including bladder preservation therapy [3]. For decades, the preferred bladder preservation method has been trimodal therapy (TMT), which combines maximal transurethral resection of bladder tumors (TURBT), chemotherapy, and external beam radiotherapy. However, the limitations of TMT are obvious, and its current clinical application rate is extremely low. For example, approximately 50% of patients are ineligible for cisplatin-based chemotherapy [4], and pelvic fibrosis caused by radiotherapy will increase the difficulty of radical surgery for patients who fail in bladder preservation therapy [3]. Bladder preservation combined-modality therapies (CMTs) based on neoadjuvant chemotherapy (NAC-CMT) [5, 6] and neoadjuvant immunotherapy (Neoimmu-CMT) [7-10] are widely used in clinical practice. Unlike chemotherapy, the tail effect of Neoimmu-CMT reactivates and boosts anticancer immunity in the periphery and tumor microenvironment (TME), maximizing the eliminati...