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Programmed death ligand-1/programmed death-1 inhibition therapy and programmed death ligand-1 expression in
1Department of Pathology and Laboratory Medicine, David Geffen School of Medicine University of California at Los Angeles, 10833 Le Conte Ave., Los Angeles, CA 90095, USA.
Abstract:
After two decades of unchanged paradigms, the treatment strategies for advanced urothelial bladder cancer have been revolutionized by emerging programmed death ligand-1 (PD-L1)/programmed death-1 (PD1) inhibition therapy. Increased evidence is demonstrating the efficacy of PD-L1/PD1 inhibition therapy in both second-line and first-line settings. However, the percentage of patients who benefit from anti-PD-L1/anti-PD1 therapy is still low. Many questions have been raised in the development of biomarker-driven approaches for disease classification and patient selection. In this perspective, we discuss PD-L1/PD1 expression in urothelial bladder carcinoma, review approved anti-PD-L1/anti-PD1 agents for bladder cancer treatment and current ongoing studies investigating combination treatment strategies, and explore PD-L1 expression status for the evaluation of bladder cancer immunotherapy.
Insights
Programmed death ligand-1 (PD-L1)/programmed death-1 (PD1) inhibitors are revolutionizing advanced urothelial bladder cancer treatment. However, low patient benefit rates highlight the need for better biomarkers to guide immunotherapy selection.
Area of Science:
- Oncology
- Immunology
- Urothelial Carcinoma Research
Background:
- Advanced urothelial bladder cancer treatment paradigms have remained static for two decades.
- Emerging programmed death ligand-1 (PD-L1)/programmed death-1 (PD1) inhibition therapy has revolutionized treatment strategies.
- Evidence supports PD-L1/PD1 inhibition in both first-line and second-line settings for bladder cancer.
Purpose of the Study:
- To discuss the role of PD-L1/PD1 expression in urothelial bladder carcinoma.
- To review approved anti-PD-L1/anti-PD1 agents and ongoing combination studies for bladder cancer.
- To explore PD-L1 expression status for evaluating immunotherapy effectiveness.
Main Methods:
- Literature review of PD-L1/PD1 expression in urothelial bladder carcinoma.
- Analysis of approved anti-PD-L1/anti-PD1 agents and combination treatment strategies.
- Exploration of PD-L1 expression as a biomarker for immunotherapy response.
Main Results:
- PD-L1/PD1 inhibition therapy shows significant efficacy in advanced urothelial bladder cancer.
- The percentage of patients benefiting from anti-PD-L1/anti-PD1 therapy remains limited.
- Biomarker-driven approaches for patient selection are crucial for optimizing immunotherapy outcomes.
Conclusions:
- PD-L1/PD1 inhibitors represent a major advancement in bladder cancer immunotherapy.
- Further research is needed to identify predictive biomarkers for patient selection.
- Optimizing immunotherapy requires a deeper understanding of PD-L1 expression and combination strategies.
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