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Development of immunotherapy in bladder cancer: present and future on targeting PD(L)1 and CTLA-4 pathways

Mathieu Rouanne1,2, Mathieu Roumiguié3,4, Nadine Houédé3,5,6

  • 1Department of Urology, Hôpital Foch, Université Versailles-Saint-Quentin-en-Yvelines, Université Paris-Saclay, 40 Rue Worth, 92150, Suresnes, France. rouanne.mathieu@gmail.com.

World Journal of Urology
|June 2, 2018
PubMed
Abstract

Insights

Immune checkpoint inhibitors (ICIs) offer new hope for advanced bladder cancer, showing significant anti-tumor activity. Further research is needed to identify biomarkers and optimize combinations for better patient responses.

Area of Science:

  • Oncology
  • Immunology
  • Urothelial Carcinoma Research

Background:

  • Advanced bladder cancer treatment has seen limited breakthroughs over 30 years.
  • Recent FDA approvals of five immune checkpoint inhibitors (ICIs) offer new therapeutic avenues.

Purpose of the Study:

  • Review clinical trial data for FDA-approved ICIs in metastatic bladder cancer.
  • Examine ongoing trials for ICIs in advanced and localized bladder cancer settings.

Main Methods:

  • Conducted a literature search on PubMed and ClinicalTrials.gov.
  • Utilized MeSH terms for urothelial carcinoma, bladder cancer, and specific immunotherapies (CTLA-4, PD-1, PD-L1) and their inhibitors.
  • Included prospective studies of anti-PD(L)1 and anti-CTLA-4 monoclonal antibodies.

Main Results:

  • Detailed evidence from early and Phase III trials of five ICIs in advanced urothelial carcinoma.
  • Reported anti-tumor activity supporting FDA approval in the second-line setting.
  • Presented data on PD(L)1 inhibitors in the first-line setting for cisplatin-ineligible patients and discussed ongoing trials in earlier disease stages.

Conclusions:

  • Blocking PD-1 or PD-L1 demonstrates significant anti-tumor activity in metastatic urothelial cancer.
  • A majority of patients do not respond to anti-PD(L)1 monotherapy.
  • Ongoing research focuses on predictive biomarkers and combination/sequential strategies to enhance treatment efficacy.
Keywords:
Bladder cancerCTLA-4Immune checkpoint inhibitorsImmunotherapyPD-1PD-L1Urothelial cancer

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