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Immune checkpoint inhibitors as a real hope in advanced urothelial carcinoma
Emmanuel Seront1,1, Gaëtan Catala1,1, Alexandre Dermine1,1
1Department of Medical Oncology, Hopital de Jolimont, 7100 Haine Saint Paul, Belgium.
Abstract:
Metastatic urothelial cancer is an aggressive disease associated with a poor prognosis. In the first-line setting, platinum-based chemotherapy is the standard of care but resistance rapidly occurs. After failure of platinum-based therapy and in cisplatin-ineligible patients, therapeutic options are limited. Malignant cells evolve mechanisms to evade immune recognition, including the expression of cell-surface molecules, named immune checkpoints, on tumor and tumor-specific lymphocytes. Immunotherapy, by targeting these checkpoints, represents a new tool to improve the patient outcome in advanced urothelial carcinoma (UC). Recently, the US FDA approved, in a short time, several immune checkpoint inhibitors in metastatic UC, both after failure of platinum-based therapy and in first-line setting in cisplatin-ineligible patients. This article aims to review the place of immunotherapy in advanced UC.
Insights
Immunotherapy offers new hope for advanced urothelial cancer (UC) by targeting immune checkpoints. This approach improves outcomes for patients resistant to chemotherapy or ineligible for cisplatin treatment.
Area of Science:
- Oncology
- Immunology
Background:
- Metastatic urothelial cancer (UC) has a poor prognosis, with platinum-based chemotherapy as standard first-line treatment.
- Chemotherapy resistance is common, and treatment options are limited for patients who fail platinum therapy or cannot receive cisplatin.
- Tumors evade immune detection via immune checkpoints, presenting a target for novel therapies.
Purpose of the Study:
- To review the role of immunotherapy in treating advanced urothelial carcinoma (UC).
- To discuss the impact of immune checkpoint inhibitors in metastatic UC.
Main Methods:
- Literature review of immunotherapy in advanced urothelial carcinoma.
- Analysis of recent FDA approvals for immune checkpoint inhibitors in UC.
Main Results:
- Several immune checkpoint inhibitors have been approved for metastatic UC.
- These approvals include both first-line settings for cisplatin-ineligible patients and settings after platinum-based therapy failure.
Conclusions:
- Immunotherapy represents a significant advancement in managing advanced urothelial cancer.
- Targeting immune checkpoints offers a promising strategy to improve patient outcomes in metastatic UC.
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