title: Immunotherapeutic strategies for bladder cancer.
abstract: Bladder cancer is a common urologic malignancy with rising incidence in the elderly population. In most cases, bladder cancer is non-muscle-invasive at diagnosis and shows dramatically high recurrence rates, although current treatments often reduce the risk of disease progression. Immunotherapy using intravesical instillation of Bacillus Calmette-Guérin (BCG) remains the most effective therapy for patients with high risk tumors. However, BCG-therapy has important limitations including substantial adverse events and frequent treatment failure. Thus, it appears crucial to either improve or replace current therapy using new immunotherapeutic strategies. Here, we discuss the clinical trials that assessed therapeutic vaccination of bladder cancer patients using tumor associated antigens and we also argue for novel approaches arising from murine models. Vaccination routes to induce appropriate T-cell homing in the tumor site as well as the use of local immunostimulation to enhance recruitment of vaccine-induced T cells are discussed to highlight what we believe is a promising therapeutic vaccination strategy for patients with non-muscle-invasive bladder cancer.
authors.affiliation: Department of Urology; Centre Hospitalier Universitaire Vaudois and University of Lausanne; Lausanne, Switzerland.
authors.forename: Mathieu F
authors.initials: MF
authors.lastname: Chevalier
authors.affiliation: Department of Urology; Centre Hospitalier Universitaire Vaudois and University of Lausanne; Lausanne, Switzerland.
authors.forename: Denise
authors.initials: D
authors.lastname: Nardelli-Haefliger
authors.affiliation: Department of Urology; Centre Hospitalier Universitaire Vaudois and University of Lausanne; Lausanne, Switzerland.
authors.forename: Sonia
authors.initials: S
authors.lastname: Domingos-Pereira
authors.affiliation: Department of Urology; Centre Hospitalier Universitaire Vaudois and University of Lausanne; Lausanne, Switzerland.
authors.forename: Patrice
authors.initials: P
authors.lastname: Jichlinski
authors.affiliation: Department of Urology; Centre Hospitalier Universitaire Vaudois and University of Lausanne; Lausanne, Switzerland.
authors.forename: Laurent
authors.initials: L
authors.lastname: Derré
mesh_terms: D000368:Aged; D019496:Cancer Vaccines / Q000008:administration & dosage* / Q000276:immunology; D002986:Clinical Trials as Topic; D006801:Humans; D007167:Immunotherapy / Q000379:methods*; D013601:T-Lymphocytes / Q000276:immunology; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000628:therapy*
chemical_list: D019496:Cancer Vaccines
keywords: BCG therapy; bladder cancer; combinatorial strategies; immunostimulants; immunotherapy; mucosal homing; therapeutic vaccination; vaccination routes