Until recently, the only viable treatment choices for patients with advanced urothelial carcinoma were platinum-based chemotherapy. In the post-platinum context, especially for patients who were ineligible for cisplatin, marginally effective second-line chemotherapy was employed, with dismal results. The approval of immune checkpoint inhibitors had drastically altered the landscape of urothelial cancer therapy. For a review, researchers examined the existing evidence that proved their effectiveness in advanced illness, as well as the ongoing trials looking at novel combination methods.
Five agents targeting the programmed cell death 1 (PD-1) pathways had been approved for use after the platinum-based chemotherapy progression since May 2016. Furthermore, atezolizumab and pembrolizumab were authorized for treatment in cisplatin-ineligible patients with high PD-L1 expression. Preliminary research revealed that they are both safe and effective as neoadjuvant treatment in muscle-invasive bladder cancer. Several ongoing trials were looking into how these drugs worked in conjunction with radiation therapy, platinum-based chemotherapy, other immune checkpoint inhibitors, and targeted medicines.
As the first- and second-line treatment, immune checkpoint inhibitors had shown long-term success in patients with advanced urothelial cancer. Various ongoing research is likely to aid in the identification of the best sequence, combination methods, as well as predictive biomarkers of response.
Reference:link.springer.com/article/10.1007/s11934-018-0851-7
