Venugopal P
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10 Mar 2023 08:34:24 AMICIs in Urological malignancies
Dear
All,
Recently
Immune Checkpoint Inhibitors (ICIs) are coming to the fore in the treatments of
all Advanced Urological Malignancies from Kidney to GCTs. Hence a good
knowledge of the various ICIs now available has become a necessity.
Though they evolved for treatment as 2nd
line (even 3rd line), recently many of them are finding its place in
primary treatments. On many occasions it was originally used as an Adjuvant regime
but recently these are used as Neoadjuvant as well. In RCC and MIBC they have
received the status of first line therapy. Recently, it is being planned for
treatments of BCG Unresponsive NMIBC as well.
But
all is not rosy as regards use of ICIs. In many the response to treatments with
ICIs are not effective and the treatments may have to be discontinued. Different
PD-L1/PD-1 antibodies have been approved for use as biomarkers for immune checkpoint
blockade in various malignancies, including the genitourinary malignancies. PD-L1
Immunohistochemical testing has been widely used across the globe as a
biomarker for immunotherapy. Positivity and negativity play an important role
to assess the effectiveness of these drugs. Additionally there are other
Biomarkers as well that will help prediction of response to ICIs.
I
am providing a review article addressing this issue as to when and how for
using ICIs in Urological malignancies.
We
have to move with time and understanding the various nuances concerning ICIs
have become a reality.
With
warm regards,
Venu
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