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Review

Breaking Barriers: Modulation of Tumor Microenvironment to Enhance Bacillus Calmette–Guérin Immunotherapy of Bladder Cancer

by
Omar M. Ibrahim
1 and
Pawel Kalinski
2,*
1
Department of Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA
2
Department of Immunology, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA
*
Author to whom correspondence should be addressed.
Cells 2024, 13(8), 699; https://doi.org/10.3390/cells13080699
Submission received: 16 February 2024 / Revised: 13 April 2024 / Accepted: 15 April 2024 / Published: 18 April 2024

Abstract

The clinical management of bladder cancer continues to present significant challenges. Bacillus Calmette–Guérin (BCG) immunotherapy remains the gold standard of treatment for non-muscle invasive bladder cancer (NMIBC), but many patients develop recurrence and progression to muscle-invasive disease (MIBC), which is resistant to BCG. This review focuses on the immune mechanisms mobilized by BCG in bladder cancer tumor microenvironments (TME), mechanisms of BCG resistance, the dual role of the BCG-triggered NFkB/TNFα/PGE2 axis in the regulation of anti-tumor and tumor-promoting aspects of inflammation, and emerging strategies to modulate their balance. A better understanding of BCG resistance will help develop new treatments and predictive biomarkers, paving the way for improved clinical outcomes in bladder cancer patients.
Keywords: tumor microenvironment; BCG; bladder cancer; urothelial cancer; chemokines; cytokines; immunotherapy; inflammation; lymphocytes; macrophages; Toll-like-receptors tumor microenvironment; BCG; bladder cancer; urothelial cancer; chemokines; cytokines; immunotherapy; inflammation; lymphocytes; macrophages; Toll-like-receptors

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MDPI and ACS Style

Ibrahim, O.M.; Kalinski, P. Breaking Barriers: Modulation of Tumor Microenvironment to Enhance Bacillus Calmette–Guérin Immunotherapy of Bladder Cancer. Cells 2024, 13, 699. https://doi.org/10.3390/cells13080699

AMA Style

Ibrahim OM, Kalinski P. Breaking Barriers: Modulation of Tumor Microenvironment to Enhance Bacillus Calmette–Guérin Immunotherapy of Bladder Cancer. Cells. 2024; 13(8):699. https://doi.org/10.3390/cells13080699

Chicago/Turabian Style

Ibrahim, Omar M., and Pawel Kalinski. 2024. "Breaking Barriers: Modulation of Tumor Microenvironment to Enhance Bacillus Calmette–Guérin Immunotherapy of Bladder Cancer" Cells 13, no. 8: 699. https://doi.org/10.3390/cells13080699

APA Style

Ibrahim, O. M., & Kalinski, P. (2024). Breaking Barriers: Modulation of Tumor Microenvironment to Enhance Bacillus Calmette–Guérin Immunotherapy of Bladder Cancer. Cells, 13(8), 699. https://doi.org/10.3390/cells13080699

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