Immune Predictors of Response after Bacillus <i>Calmette–Guérin</i> Treatment in Non-Muscle-Invasive Bladder Cancer
Bacillus Calmette–Guérin (BCG) has been the standard of care for the treatment of high-risk, non-muscle-invasive bladder cancer (NMIBC) for decades, but 49.6% of high-risk and very-high-risk patients will experience progression to muscle-invasive disease in five years. Furthermore, cytology and cyst...
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MDPI AG
2023-11-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/15/23/5554 |
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| author | Marta Rodríguez-Izquierdo Carmen G. Del Cañizo Carolina Rubio Ignacio A. Reina Mario Hernández Arroyo Alfredo Rodríguez Antolín Marta Dueñas Porto Félix Guerrero-Ramos |
| author_facet | Marta Rodríguez-Izquierdo Carmen G. Del Cañizo Carolina Rubio Ignacio A. Reina Mario Hernández Arroyo Alfredo Rodríguez Antolín Marta Dueñas Porto Félix Guerrero-Ramos |
| author_sort | Marta Rodríguez-Izquierdo |
| collection | DOAJ |
| description | Bacillus Calmette–Guérin (BCG) has been the standard of care for the treatment of high-risk, non-muscle-invasive bladder cancer (NMIBC) for decades, but 49.6% of high-risk and very-high-risk patients will experience progression to muscle-invasive disease in five years. Furthermore, cytology and cystoscopy entail a high burden for both patients and health care systems due to the need for very long periods of follow-up. Subsequent adjuvant treatment using intravesical immunotherapy with BCG has been shown to be effective in reducing tumor recurrence and progression, but it is not free of severe adverse effects that ultimately diminish patients’ quality of life. Because not all patients benefit from BCG treatment, it is of paramount importance to be able to identify responders and non-responders to BCG as soon as possible in order to offer the best available treatment and prevent unnecessary adverse events. The tumor microenvironment (TME), local immune response, and systemic immune response (both adaptive and innate) seem to play an important role in defining responders, although the way they interact remains unclear. A shift towards a proinflammatory immune response in TME is thought to be related to BCG effectiveness. The aim of this review is to collect the most relevant data available regarding BCG’s mechanism of action, its role in modulating innate and adaptive immune responses and the secretion of certain cytokines, and their potential use as immunological markers of response; the aim is also to identify promising lines of investigation. |
| first_indexed | 2024-03-09T01:54:10Z |
| format | Article |
| id | doaj.art-b9f262f6b4df4a309297bf924fe609e0 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-09T01:54:10Z |
| publishDate | 2023-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-b9f262f6b4df4a309297bf924fe609e02023-12-08T15:12:32ZengMDPI AGCancers2072-66942023-11-011523555410.3390/cancers15235554Immune Predictors of Response after Bacillus <i>Calmette–Guérin</i> Treatment in Non-Muscle-Invasive Bladder CancerMarta Rodríguez-Izquierdo0Carmen G. Del Cañizo1Carolina Rubio2Ignacio A. Reina3Mario Hernández Arroyo4Alfredo Rodríguez Antolín5Marta Dueñas Porto6Félix Guerrero-Ramos7Department of Urology, University Hospital 12 Octubre, 28041 Madrid, SpainDepartment of Urology, University Hospital 12 Octubre, 28041 Madrid, SpainMolecular and Traslational Oncology Division, Biomedical Innovation Unit, CIEMAT, 28040 Madrid, SpainMolecular and Traslational Oncology Division, Biomedical Innovation Unit, CIEMAT, 28040 Madrid, SpainDepartment of Urology, University Hospital 12 Octubre, 28041 Madrid, SpainDepartment of Urology, University Hospital 12 Octubre, 28041 Madrid, SpainMolecular and Traslational Oncology Division, Biomedical Innovation Unit, CIEMAT, 28040 Madrid, SpainDepartment of Urology, University Hospital 12 Octubre, 28041 Madrid, SpainBacillus Calmette–Guérin (BCG) has been the standard of care for the treatment of high-risk, non-muscle-invasive bladder cancer (NMIBC) for decades, but 49.6% of high-risk and very-high-risk patients will experience progression to muscle-invasive disease in five years. Furthermore, cytology and cystoscopy entail a high burden for both patients and health care systems due to the need for very long periods of follow-up. Subsequent adjuvant treatment using intravesical immunotherapy with BCG has been shown to be effective in reducing tumor recurrence and progression, but it is not free of severe adverse effects that ultimately diminish patients’ quality of life. Because not all patients benefit from BCG treatment, it is of paramount importance to be able to identify responders and non-responders to BCG as soon as possible in order to offer the best available treatment and prevent unnecessary adverse events. The tumor microenvironment (TME), local immune response, and systemic immune response (both adaptive and innate) seem to play an important role in defining responders, although the way they interact remains unclear. A shift towards a proinflammatory immune response in TME is thought to be related to BCG effectiveness. The aim of this review is to collect the most relevant data available regarding BCG’s mechanism of action, its role in modulating innate and adaptive immune responses and the secretion of certain cytokines, and their potential use as immunological markers of response; the aim is also to identify promising lines of investigation.https://www.mdpi.com/2072-6694/15/23/5554bladder cancerBacillus <i>Calmette–Guérin</i>cytokinestumor microenvironmentimmune response |
| spellingShingle | Marta Rodríguez-Izquierdo Carmen G. Del Cañizo Carolina Rubio Ignacio A. Reina Mario Hernández Arroyo Alfredo Rodríguez Antolín Marta Dueñas Porto Félix Guerrero-Ramos Immune Predictors of Response after Bacillus <i>Calmette–Guérin</i> Treatment in Non-Muscle-Invasive Bladder Cancer Cancers bladder cancer Bacillus <i>Calmette–Guérin</i> cytokines tumor microenvironment immune response |
| title | Immune Predictors of Response after Bacillus <i>Calmette–Guérin</i> Treatment in Non-Muscle-Invasive Bladder Cancer |
| title_full | Immune Predictors of Response after Bacillus <i>Calmette–Guérin</i> Treatment in Non-Muscle-Invasive Bladder Cancer |
| title_fullStr | Immune Predictors of Response after Bacillus <i>Calmette–Guérin</i> Treatment in Non-Muscle-Invasive Bladder Cancer |
| title_full_unstemmed | Immune Predictors of Response after Bacillus <i>Calmette–Guérin</i> Treatment in Non-Muscle-Invasive Bladder Cancer |
| title_short | Immune Predictors of Response after Bacillus <i>Calmette–Guérin</i> Treatment in Non-Muscle-Invasive Bladder Cancer |
| title_sort | immune predictors of response after bacillus i calmette guerin i treatment in non muscle invasive bladder cancer |
| topic | bladder cancer Bacillus <i>Calmette–Guérin</i> cytokines tumor microenvironment immune response |
| url | https://www.mdpi.com/2072-6694/15/23/5554 |
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