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Updated: Dec 20, 2025

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[Second-line treatment of metastatic urothelial carcinoma : Update immuno-oncology]

S Zschäbitz1, G Niegisch2

  • 1Universitätsklinikum Heidelberg, Nationales Centrum für Tumorerkrankungen (NCT) Heidelberg, Heidelberg, Deutschland. stefanie.zschaebitz@med.uni-heidelberg.de.

Der Urologe. Ausg. A
|May 31, 2020
PubMed

Insights

Checkpoint inhibitors (CPI) like pembrolizumab, nivolumab, and atezolizumab are now standard second-line treatments for advanced urothelial carcinoma. These therapies offer a better toxicity profile than traditional chemotherapy.

Area of Science:

  • Oncology
  • Immunotherapy
  • Urothelial Carcinoma Treatment

Background:

  • PD-1 and PD-L1 antibodies have transformed urothelial carcinoma treatment.
  • Checkpoint inhibitors (CPI) are now standard in second-line therapy.
  • CPI offer a superior toxicity profile compared to chemotherapy.

Purpose of the Study:

  • To provide an overview of current second-line treatment strategies.
  • To highlight the role of CPI in advanced urothelial carcinoma.
  • To discuss the shift from chemotherapy to immunotherapy.

Main Methods:

  • Review of current clinical guidelines and literature.
  • Analysis of efficacy and toxicity data for CPI.
  • Comparison of CPI with traditional chemotherapeutics.

Main Results:

  • Pembrolizumab, nivolumab, and atezolizumab are established CPI therapies.
  • CPI demonstrate significant efficacy in second-line settings.
  • CPI exhibit a more favorable safety profile than vinflunine, paclitaxel, and docetaxel.

Conclusions:

  • CPI represent the standard of care for second-line treatment of advanced urothelial carcinoma.
  • The therapeutic landscape has shifted towards immunotherapy.
  • Further research may explore optimal sequencing and combination strategies.
Keywords:
Bladder cancerCheckpoint InhibitionImmunotherapyProgrammed cell death ligand 1Programmed cell death 1

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