Until recently, patients with locally advanced or metastatic urothelial carcinoma after progression on cisplatin-containing chemotherapy had limited systemic treatment options with no significant survival benefit and poor tolerability. Advances in the field of immunotherapy with the introduction of checkpoint inhibitors have led to paradigm shifts in the treatment of various malignancies. Areas covered: The current review will summarize the clinical evidence of checkpoint inhibitors in bladder cancer, with a focus on pembrolizumab. Expert commentary: Category 1 evidence indicates that the checkpoint inhibitor pembrolizumab improves overall survival in patients with locally advanced or metastatic urothelial carcinoma who progressed after or during cisplatin-containing therapy as compared to current standard of care chemotherapy. Phase 1 and 2 evidence also indicates that checkpoint inhibitors are active in first line in patients who are ineligible for cisplatin-containing chemotherapy.
Expert review of anticancer therapy. 2017 Dec 29 [Epub ahead of print]
Nora Sundahl, Sylvie Rottey, Daan De Maeseneer, Piet Ost
a Department of Radiation-Oncology and Experimental Cancer Research , University Hospital Ghent , Ghent , Belgium., c Department of Medical Oncology , University Hospital Ghent , Ghent , Belgium.