Immunothérapie

Immunotherapy in the treatment of bladder cancer

Immunotherapy in the treatment of bladder cancer
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Immunotherapy is the use of the body’s immune system to fight bladder cancer.

Immunotherapy treatments stimulate the immune system so that it can recognize and destroy cancer cells.

Immunotherapy is sometimes helpful in treating bladder cancer.

 

BCG intravenical instillations

They are indicated only in certain early forms of superficial bladder cancer.

BCG or Calmette and Guérin bacillus is an attenuated TB bacillus. It does not usually cause illness in people to whom it is given. However, it can stimulate the immune response.

BCG is introduced directly into the bladder via a urinary catheter into a liquid solution.

This intravenous BCG instillation stimulates the immune system within the bladder itself. Immune system cells concentrate in the bladder wall to attack and destroy bladder cancer cells.

This treatment is indicated only in early forms of superficial bladder cancer. It is often used after trans-urethral resection of the bladder tumor to prevent recurrence.

Immunotherapy with the inhibitors of the control points

It is indicated only in advanced bladder cancers.

One of the characteristics of the immune system is its ability to avoid acting on normal body cells.

To do this, the immune system uses “point of control” molecules that are placed on the immune cells.

These control points must be either activated or inactivated to obtain an immune response.

Cancer cells sometimes appropriate these control points to avoid the action of the immune system.

The new therapies that target these checkpoints are very promising in the fight against cancer.

1. ATEZOLIZUMAB (TECENTRUQ), DURVALUMAB (IMFINZI), and AVELUMAB (BAVENCIO) are the molecules that target PD-L1.

This protein is located on the body’s cells, usually healthy cells, but also sometimes on cancer cells.

It prevents the immune system from targeting and attacking these cells.

By blocking PD-L1, these molecules activate the immune response against cancer cells. They can significantly decrease tumor volume or limit tumour growth.

2. NIVOLUMAB (OPDIVO) and PEMBROLIZUMAB (KEYTRUDA) target PD-1, another protein that usually prevents the immune system from attacking the cell.

These molecules block PD-1 to facilitate the immune response against cancer cells.

This type of treatment is indicated for people with advanced bladder cancer, especially after recurrence following chemotherapy.

3. ATEZOLIZUMAB and PEMBROLIZUMAB may also be used in patients who cannot be administered CISPLATIN.

These treatments are usually administered intravenously every 2-3 weeks.

 

Possible side effects

Unwanted side effects of these treatments usually include fatigue, nausea, loss of appetite, fever, urinary tract infections, skin rashes, diarrhea and constipation.

Less often, more serious side effects may occur. These treatments act by inactivating the immune system’s brakes. Sometimes the immune system affects other organs that were not affected by cancer, which can lead to serious complications, which can lead to life-threatening prognosis, especially when the damage is in the lungs, intestines, liver or endocrine glands.

Early diagnosis of these serious complications is desirable, so that these treatments can be stopped immediately and high doses of corticosteroids administered to try to inhibit the immune response.