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Updated: Jun 21, 2025
An Orthotopic Bladder Cancer Model for Gene Delivery Studies
Published on: December 1, 2013
Advancements in First-Line Treatment of Metastatic Bladder Cancer: EV-302 and Checkmate-901 Insights and Future
Vijay Kumar Srinivasalu1, Debbie Robbrecht2
1Department of Medical Oncology, Pantai Jerudong Specialist Center, The Brunei Cancer Center, Jerudong BG3122, Brunei.
Abstract:
Advanced bladder cancer patients have historically failed to achieve prolonged duration of response to conventional chemotherapy and needed better first-line treatment regimens. The approval of nivolumab in combination with gemcitabine and cisplatin and pembrolizumab with antibody-drug conjugate enfortumab vedotin has revolutionized the first-line treatment of advanced bladder cancer in many countries. In this review, we summarize the intricate differences between the two landmark clinical trials that led to their incorporation into the current standard of care for advanced bladder cancer. We further discuss newer novel treatment options in the second and subsequent lines of treatment on progression, like immunotherapy in combination with other agents, including fibroblast growth factors receptor inhibitors, human epidermal growth factor inhibitors, antibody-drug conjugates, tyrosine kinase inhibitors, and novel antibodies. Finally, we discuss the integration of these novel therapies into current clinical practice amidst the rapidly evolving landscape of advanced bladder cancer treatment, aiming to enhance patient outcomes.
Insights
Newer treatments like nivolumab and pembrolizumab combinations have transformed advanced bladder cancer care. This review details these advances and explores emerging therapies for improved patient outcomes in first-line and later treatment stages.
Area of Science:
- Oncology
- Medical treatment of advanced bladder cancer
Background:
- Advanced bladder cancer historically showed poor response to chemotherapy.
- Recent approvals of novel combination therapies have significantly improved treatment paradigms.
Purpose of the Study:
- To review landmark trials comparing first-line treatments for advanced bladder cancer.
- To discuss emerging therapies for second-line and subsequent treatment of advanced bladder cancer.
- To guide the integration of novel therapies into clinical practice.
Main Methods:
- Review of pivotal clinical trials for first-line advanced bladder cancer treatment.
- Analysis of emerging therapeutic strategies for advanced bladder cancer progression.
- Discussion on the clinical integration of novel agents.
Main Results:
- Nivolumab plus gemcitabine/cisplatin and pembrolizumab with enfortumab vedotin represent revolutionary first-line options.
- A range of novel agents are available for subsequent lines of therapy, including immunotherapies, targeted agents, and antibody-drug conjugates.
Conclusions:
- The treatment landscape for advanced bladder cancer has been revolutionized by new first-line regimens.
- Careful consideration of novel agents in later lines of treatment is crucial for enhancing patient outcomes.
- Integration of these therapies requires navigating a rapidly evolving clinical environment.
