Safety and efficacy of immunotherapy in the treatment of genitourinary tract tumors

master's thesis

• Title (croatian): Učinkovitost i sigurnost imunoterapije u liječenju tumora genitourinarnog trakta
• Author: Ador Peltzman
• Mentor: Robert Likić (mentor)
• Committee member: Robert Likić (predsjednik povjerenstva)
• Committee member: Borislav Belev (član povjerenstva)
• Committee member: Jasenka Markeljević (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; Zagreb
• Defense date and country: 2021-10-06, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

Genitourinary tract tumors are found in the urinary system and the male reproductive system. These tumors can occur anywhere along the urinary tract, including the bladder, kidney, prostate, ureters, and testicles. Urothelial carcinoma (UC), also known as transitional cell carcinoma, accounts for 95% of bladder cancers and 10% of all primary renal cancers.
Chemotherapy remains the primary treatment for urothelial carcinoma, but progression-free survival (PFS) and overall survival (OS) are short. In addition, the recurrence rate is high, and many patients are not eligible for chemotherapy due to adverse events and comorbidities.
Immunotherapy and immune checkpoint inhibitors (ICIs) in particular have gained popularity in recent years in the management of many types of cancers. Certain cancers utilize upregulation of immune checkpoints, which leads to inhibition of immune cell activation, and allows the cancer cells to evade immune surveillance. ICIs block the immune checkpoint proteins (such as CTLA4, PD-1, and PD-L1), thus restoring the immune system’s function against the cancer cells.
Multiple ongoing clinical trials are currently evaluating the safety and efficacy of ICIs and new combination therapies in treating patients with advanced malignancies compared to standard chemotherapy.
This review is a compilation of the latest information based on results from multiple clinical trials about the safety and effectiveness of immunotherapy used in major urogenital tumors (bladder cancer, kidney cancer, prostate cancer, testis cancer, upper urinary tract cancer).

Abstract (croatian)

Tumori genitourinarnog trakta su tumori urinarnog sustava te muških reproduktivnih organa. Ovi tumor mogu nastati na bilo mjestu u urinarnom traktu, uključujući mokraćni mjehur, bubrege, prostatu, uretere i testise. Urotelijalni karcinom (UC), poznat i pod nazivom karcinom prijelaznog epitela, čini 95% svih karcinoma mokraćnog mjehura i do 10% svih primarnih karcinoma bubrega.
Kemoterapija ostaje primarna vrsta liječenja urotelnih karcinoma, no preživljenje bez progresije bolesti (progression free survival -PFS) te ukupno preživljenje (overall survival – OS) su kratki. Dodatno, postotak relapse je visok, a mnogi pacijenti nisu dobri kandidati za kemoterapiju zbog komorbiditeta ili nuspojava.
Imunoterapija i primjena inhibitora kontrolnih točaka zadnjih godina dobivaju na značaju u terapiji mnogih vrsta tumora. Neke vrste tumora moduliraju imuni sustav uzrokujući inhibiciju aktivacije imunih stanica, te stanice tumora na taj način izbjegavaju reakciju imunog sustava. Inhibitori kontrolnih točaka blokiraju imunoregulatorne proteine (poput CTLA4, PD-1 i PD-L1), te na taj način iznova omogućuju reaktivnost imunog sustava prema tumorskim stanicama.
Brojna klinička istraživanja trenutno evaluiraju sigurnost i učinkovitost inhibitora kontrolnih točaka u monoterapiji ili u kombinaciji s drugim lijekovima u liječenju pacijenata s uznapredovalim malignim bolestima u usporedbi s klasičnom kemoterapijom.
Ovaj pregledni diplomski rad obrađuje najnovije rezultate kliničkih istraživanja u pogledu sigurnosti i učinkovitosti imunoterapije u liječenju glavnih tipova urogenitalnih tumora (karcinom mokraćnog mjehura, karcinom bubrega, karcinom prostate, karcinom testisa, karcinomi proksimalnog dijela urinarnog trakta).

• Keywords: genitourinary tract tumors; immunotherapy; immune checkpoint inhibitors; clinical trials
• Keywords (croatian): tumori genitourinarnog trakta; imunoterapija; inhibitori kontrolnih točaka; klinička istraživanja
• Language: english
• URN:NBN: urn:nbn:hr:105:951603
• Study programme: Title: Medicine (in English language); Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2022-12-21 12:40:54