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Neoadjuvant Immunotherapy for Muscle-Invasive Bladder Cancer
Arthur Peyrottes1, Idir Ouzaid1, Gianluigi Califano1,2
1Department of Urology, Bichat-Claude Bernard Hospital, Assistance-Publique-Hôpitaux de Paris, Université de Paris, 75018 Paris, France.
Medicina (Kaunas, Lithuania)
|August 27, 2021
Summary
Neoadjuvant immunotherapy using immune checkpoint inhibitors shows promising pathological response rates in early-stage muscle-invasive bladder cancer. Further research is needed to confirm efficacy and guide clinical use.
Area of Science:
- Oncology
- Immunology
- Urology
Background:
- Neoadjuvant immunotherapy represents an innovative approach for localized muscle-invasive bladder cancer.
- Immune checkpoint inhibitors (ICIs) are being investigated for early-stage bladder cancer treatment.
Purpose of the Study:
- To review existing and ongoing evidence for ICI administration in localized muscle-invasive bladder cancer.
- To evaluate the efficacy, toxicity, and biomarkers of response for neoadjuvant ICIs.
Main Methods:
- Literature search of Medline and clinical trials databases.
- Inclusion of prospective clinical trials evaluating anti-PD-(L)1 and anti-CTLA-4 monoclonal antibodies.
- Data extraction on efficacy, toxicity, and response biomarkers.
Main Results:
- Six ICIs (4 anti-PD-(L)1, 2 anti-CTLA-4) were identified in neoadjuvant trials.
- Pathological complete response rates (pCR) ranged from 31% to 46%.
- Acceptable safety profile with severe treatment-related adverse events from 6% to 41%.
Conclusions:
- Early-phase trial results for neoadjuvant ICIs in bladder cancer are encouraging.
- Further investigation is required to solidify the role of ICIs in this setting.
