Jonathan L. Wright, MD, MS, FACS, medical director, Urology Clinic, University of Washington Medical Center, affiliate investigator, Fred Hutchinson Cancer Research Center, Seattle Cancer Care Alliance, discusses the role of immunotherapy in the treatment of patients with bladder cancer.
Over the past few years, immunotherapy has made a significant impact in the treatment of upper tract urothelial and bladder cancers. Primarily, checkpoint inhibitors are being used upfront in the metastatic setting for patients with bladder cancer who are ineligible to receive cisplatin-based chemotherapy. Ongoing work is being done to see if immunotherapy has a role in the neoadjuvant setting and in patients with nonmuscle–invasive disease, Wright says.
In 2018 alone, there were 7 FDA approvals for immunotherapy agents in bladder cancer—5 drugs in the second-line setting for recurrent patients and 2 for frontline therapy; however, these checkpoint inhibitors have not yet been tested head-to-head in clinical trials.
