Haneyskaarup4569

It is used when neoadjuvant chemotherapy has been utilized and the cystectomy pathology report is locally advanced. The best outcomes are for low-volume node positive patients.In bladder preservation protocols (aiming to decreased morbidity associated with cystectomy and chemotherapy), several regimens have been utilized in combination with radiation therapy. No standardized treatmentis available as no comparisons with cystectomy have been done.

Chemotherapy has been utilized for several decades in muscle invasive bladder cancer without any major survival improvements or decreaseon side-effects. That is the rational why the treatment regimen are widely different amongst groups without a standard treatment.

Chemotherapy has been utilized for several decades in muscle invasive bladder cancer without any major survival improvements or decreaseon side-effects. That is the rational why the treatment regimen are widely different amongst groups without a standard treatment.Non-muscle invasive bladder cancer (NMIBC) is a highly heterogeneous disease that hides classes of patients who behave significantly differently under a favorable overall prognosis facade. Individual risk stratification and good decision making improve the patient outcomes. To date, radical cystectomy remains the treatment of choice in particularly aggressive subsets of disease, also due to the lack of proven alternative bladder-sparing strategies.Cancer immunotherapy, by inhibiting the PD-1/PD-L1axis, has shown durable efficacy in the treatment of advanced and metastatic unresectable urothelial carcinoma, and is studied with great interest in early disease settings. The updated data of the KEYNOTE-057 study have recently promoted the United States (US) Food and Drug Administration (FDA) approval of pembrolizumabin patients with CIS-containing BCG-unresponsive NMIBC. This significant step forward paves the way to a new window of therapeutic opportunities, while underlining new needs and questions to be addressed.Non-muscle invasive bladder cancer has a high recurrence and progression rate. click here Endovesical administration of chemotherapy after transurethral resection of bladder tumors aims to minimize the recurrence and progression rates. Over last decades BCG and MMC have been gold standard treatments. Still alarge proportion of patients recur and progress. Altogether with periods of BCG shortage has facilitate the search for alternatives. In the current manuscript we review the current drug sunder study including chemotherapy, immunotherapy and gene therapy. We also updated results on recent findings on means of intravesical administration, including hyperthermia assisted by external devices. The objectives of our products are implementing new efficient and safe alternatives and the development of technologies that increase of currently used drugs. After years without improvements in the field, nowadays we have a myriad of options available. Some of those new devices will remain and reach general urologist for their applicability. Preliminary results are promising and a positive environment surrounds the urologist in charge of bladder cancer.BCG is currently the standard of care in intermediate and high risk non-invasive bladder tumors. In high-risk patients treated with BCG up to 30% will recurand 10% will progress within 2 years. Oncological outcomes with bladder preserving strategies are limited so radical cystectomy is recommended after BCG failure. Some promising treatments, such as check point inhibitors (PD1, PDL-1), are being studied for non-responders to BCG. Knowing the management of critical situations during BCG treatment its crucial in daily practice and clinical trials design. The aim of this study is to present these definitions and to remember some important aspect sof BCG management.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.Anti CTLA-4, anti PD-L1 and anti PD-1immune check point inhibitors (ICI) down regulate natural inhibitory pathways of the immune system, in turn increasing tumour surveillance and elimination. Cancer treatment through immune regulation has revolutionised many cancer therapies. However, these new treatments have also brought unique immune related adverse events (irAEs).

This paper presents a review of the available knowledge regarding irAE grading, incidence, diagnosis and management, serving as a clinical aid forall clinicians involved with ICI therapy.

A comprehensive English-language literature research of original and review articles in the Medline database until June 2020 hasbeen carried out, using the MeSH terms "immune checkpoint inhibitor toxicities" and "immune related adverseevent".

Further research should aim to investigate if the greater effect of combining ICI treatments issufficient to justify the increased risk of complications, as well as to identify specific subgroups that will benefit the most from these.

Further research should aim to investigate if the greater effect of combining ICI treatments issufficient to justify the increased risk of complications, as well as to identify specific subgroups that will benefit the most from these.Bladder cancer was one of the first to have a successful treatment based on immune system stimulation, recognized by patient survival and tumor recurrence data. In addition, bladder tumors are now known to have high antigenic load and are therefore considered to be susceptible to respond well to new immunotherapies. For these reasons, studying the mechanism of action of bladder cancer immunological-based treatments can provide valuable information both to improve their current use and to under stand why they work in some patients while others do not tolerate this therapy or have tumor progression. In this article, we will focus on the immune response generated by treatment of non-muscle invasive bladder tumors with BCG, as well as the relationship between this knowledge and new immunotherapies. We will first describe the main activities of the immune system, to continue with the treatment of bladder cancer with BCG, its mechanism of action and biomarkers. Finally, we will summarize the observations that led to the useof monoclonal antibody immunotherapy in cancer and will describe some of the new immunotherapies in use to treat bladder cancer patients.Therapeutic approaches for treatment of urothelial transitional cell carcinoma based on immune system modulation, as well as the contribution of intravesica Bacillus de Calmette-Guérin (BCG) and the recentin corporation of checkpoint inhibitors had found irrefutable proofs of concept for the indication of antitumoral immunontherapy in such tumors. Its extension and development at the present time covers all the locations of the wide spectrum of presentation and evolution of these tumors. Nowadays, apart for the low grade non muscle-invasive tumors, we are facingan unpredictable development of antitumoral immunotherapy in bladder cancer not only as an option in the primary treatment, but also in other scenarios such asnon-responders when it comes to BCG, or the situation of ineligibility for systemic chemotherapy indication. The main objective of this review article is trying to translate the current basic mechanisms involved in different phases of transitional cell carcinomas antitumoral response, regardless of whether they are muscle-invasive or not, and to establish the rationale for their therapeutic intravesical or systemic administration. The role of the interactions established between urothelial tumor cells and the cellular and molecular elements of the immune system of patients is described, incorporating the relevant and recent advances in immunobiology and the molecular characterization of these tumors thatwill undoubtedly introduce far-reaching modifications intherapeutic regimes that will contrast with the traditional options available. Investigational lines that are already active in the clinical research phase with BCG and, checkpoints inhibitors ofthe immune response are also analyzed, high lighting theneed to find predictive response markers as a real option for treatments personalization. The approach to the knowledge of the individual reactivity of the immune system of each patient as a determining factor to achieve it is proposed.Bladder cancer is the seventh most frequent cancer on male population and eleventh within the whole inhabitants. Differences in incidence and mortality between countries and regions exist. Those differences depend on variables including epidemiological data, social and cultural features and economics amongst the several populations that are exposed to different risk factors and treatment approaches. Smoking is the strongest risk factor for bladder cancer, representing approximately 50% of the cases. Its alternative, the electronic cigarette does not seem to providea decrease in risk of bladder cancer. Employment exposure to aromatic amines, aromatic polycyclic hydrocarbons and chlorate hydrocarbons, are still important risk factors. Water consumption with high levels of arsenic has also shown an increased risk of bladder cancer. Fast acetylators or genetic predisposition would be tentative risk factors. Some medical treatments with chemotherapy oradiation therapy increase bladder cancer risk. Identifying all these factors allows for progress in the field of prevention and early detection. The main objective is to decrease incidence and mortality related to bladder cancer.Archivos Españoles de Urología finaliza el año 2020, un año difícil que todos recordaremos con tristeza como el año del Covid, editando un Número Monográfico que es pura Ciencia y Novedad ,y que también tendrá un largo recorrido en la Memoria de cuantos lo estudien o lo lean, titulado NUEVOS PARADIGMAS EN EL CÁNCER VESICAL La importancia y relevancia del Tema seleccionado es y será notoria en tanto podemos afirmar con toda seguridad que durante 2021 y siguientes años, los artículos contenidos en el mismo, serán motivo de referencia, presentaciones, ponencias y debates en todos los foros nacionales e internacionales en los que se aborde el manejo y tratamiento del Cáncer Vesical...

A steady decline of the smoking prevalence in Sweden has been recorded over the past decade; however, people still start and continue to smoke. There is a need for effective smoking cessation interventions that can scale to a national level and that are designed to reach individuals requiring smoking cessation support in the general population.

Previous randomized controlled trials of smoking cessation interventions among high school and university students in Sweden have found consistent evidence that text messaging interventions are effective in helping students quit smoking. However, there are no studies that investigate the effects of text messaging interventions in a more general population. The objective of this study is to estimate the effects of a text messaging intervention on individuals seeking help to quit online and individuals visiting primary health care units.

A 2-arm, parallel-group (11), randomized controlled trial will be employed to address the study objectives. The trial will follow a Bayesian group sequential design.