Although immunotherapy has a long history in the treatment of urothelial carcinoma, its use was limited to intravesical therapy for non-muscle-invasive disease. The development of immune checkpoint blockers for systemic delivery has expanded the application of immunotherapy to advanced metastatic urothelial cancers.
The PubMed database was searched for publications regarding immune checkpoint blockers for the treatment of patients with urothelial carcinoma. Relevant congress abstracts were identified through searches of individual congress websites.
A summary of the biology and immunology of urothelial carcinoma is provided for context to aid discussion of key data pertaining to immune checkpoint blockers that are approved and in development. We address immune-mediated adverse events that are unique to immunotherapies and review diagnostic tools that may be useful in the identification of patients who would most benefit from immunotherapy.
Immunotherapies for the treatment of urothelial carcinoma have shown clinical efficacy in selected patients, as well as a manageable safety profile. Studies are ongoing, with the aim of expanding the proof of efficacy in metastatic disease and providing additional treatment options for patients with earlier stages of urothelial carcinoma.
The Journal of urology. 2017 Nov 04 [Epub ahead of print]
Arlene O Siefker-Radtke, Andrea B Apolo, Trinity J Bivalacqua, Philippe E Spiess, Peter C Black
MD Anderson Cancer Center, Houston, TX, USA. Electronic address: ., National Cancer Institute, Bethesda, MD, USA., The James Buchanan Brady Urological Institute, Johns Hopkins Medicine, Baltimore, MD, USA., Moffit Cancer Center, Tampa, FL, USA., University of British Columbia, Vancouver, British Columbia, Canada.