Recent developments in the treatment of advanced bladder cancer

Urol Oncol. 2018 Mar;36(3):109-114. doi: 10.1016/j.urolonc.2017.12.018. Epub 2018 Feb 1.

Abstract

Urothelial carcinoma of the bladder is a common malignancy which has historically been difficult to treat in its advanced stages. Clinically effective treatment options for locally advanced/inoperable or metastatic urothelial carcinoma (mUC) consisted of cisplatin-based chemotherapy regimens, with few other impactful therapeutic options. The past 2 years have seen a remarkable shift in the therapeutic landscape of mUC, with 5 novel immunotherapy agents receiving FDA approval for mUC, including first-line and second-line postplatinum settings. There are now many important clinical trials ongoing seeking to answer how best to use chemotherapy, immunotherapy, and targeted therapy agents in patients with mUC. Here we review the current standard of care for patients with mUC based on published data from the past 2 years, and look forward toward future research directions.

Keywords: Bladder cancer; Checkpoint inhibitors; Chemotherapy; Clinical trials; Immunotherapy; Platinum ineligible; Targeted therapy; Urothelial carcinoma.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents, Immunological / therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • B7-H1 Antigen / antagonists & inhibitors
  • Carcinoma, Transitional Cell / immunology
  • Carcinoma, Transitional Cell / pathology
  • Carcinoma, Transitional Cell / therapy*
  • Cisplatin / therapeutic use
  • Clinical Trials as Topic
  • Humans
  • Immunotherapy / methods*
  • Immunotherapy / trends
  • Programmed Cell Death 1 Receptor / antagonists & inhibitors
  • Treatment Outcome
  • Urinary Bladder / pathology
  • Urinary Bladder Neoplasms / immunology
  • Urinary Bladder Neoplasms / pathology
  • Urinary Bladder Neoplasms / therapy*

Substances

  • Antineoplastic Agents, Immunological
  • B7-H1 Antigen
  • CD274 protein, human
  • PDCD1 protein, human
  • Programmed Cell Death 1 Receptor
  • Cisplatin