[Immunotherapy in urothelial carcinoma from a pathologist's perspective]

Area of Science:

• Urooncology
• Immunotherapy
• Cancer Treatment

Background:

• Programmed cell death protein-1 (PD-1) antibodies (pembrolizumab, nivolumab) are approved for first-line treatment of several tumors, including malignant melanoma.
• The success of these antibodies has led to investigations into their potential for urological tumors.
• Nivolumab (PD-1 antibody) and atezolizumab (programmed cell death ligand 1 [PD-L1] antibody) approvals mark significant advancements in urooncology.

Purpose of the Study:

• To review the efficacy and application of checkpoint inhibitors in urological tumors.
• To highlight the advancements in immunotherapy for urothelial carcinoma and renal cell carcinoma.
• To address the challenges in standardizing immunohistochemical evaluation for immunotherapy selection.

Main Methods:

• Review of clinical trials and approvals of PD-1 and PD-L1 inhibitors in urooncology.
• Analysis of the current landscape of immunotherapy in advanced urothelial carcinoma and metastatic renal cell carcinoma.
• Discussion of the role of immunohistochemistry in patient selection for immunotherapy.

Main Results:

• PD-1 and PD-L1 inhibitors have demonstrated significant efficacy in advanced urothelial carcinoma and metastatic renal cell carcinoma.
• Ongoing clinical trials continue to show promising results for checkpoint inhibitors in urothelial carcinoma.
• Standardization of immunohistochemical evaluation protocols and detection systems is lacking, hindering comparative efficacy assessment.

Conclusions:

• Immunotherapy with PD-1 and PD-L1 antibodies represents a new standard of care in advanced urothelial carcinoma and renal cell carcinoma.
• Further research and standardization are crucial for optimizing immunotherapy selection and treatment outcomes in urooncology.
• Consistent evaluation methods are essential for comparing the efficacy of different checkpoint inhibitors.