How Immunotherapy Has Redefined the Treatment Paradigm of Metastatic or Locally Advanced Muscle-Invasive Urothelial Bladder Carcinoma

Author:

Larroquette Mathieu12ORCID,Lefort Félix1ORCID,Domblides Charlotte13ORCID,Héraudet Luc1,Robert Grégoire4ORCID,Ravaud Alain1,Gross-Goupil Marine1ORCID

Affiliation:

1. Medical Oncology Department, Hôpital Saint André, University Hospital of Bordeaux, 33076 Bordeaux, France

2. Bordeaux University, CNRS UMR 5095, IBGC, 33076 Bordeaux, France

3. ImmunoConcEpt, CNRS UMR 5164, Bordeaux University, 33076 Bordeaux, France

4. Urology Department, University Hospital of Bordeaux, 33076 Bordeaux, France

Abstract

In the past decade, the therapeutic arsenal for metastatic bladder cancer has expanded considerably, with the development of immune checkpoint inhibitors (ICIs), antibody–drug conjugates such as enfortumab vedotin, and anti-fibroblast growth factor receptor agents. Clinical trials evaluating ICIs as neoadjuvants, adjuvants, or first- or second-line treatments have produced conflicting results. However, first-line therapeutic strategies have been redefined by the recent publication of results from two clinical trials: CheckMate-901, which demonstrated the superiority of combined treatment with nivolumab and chemotherapy in extending overall survival, and EV-302, which demonstrated that combined treatment with pembrolizumab and enfortumab vedotin reduced the risk of death by 53%. In this review, we discuss the role of ICIs, alone or in combination, in bladder cancer management in the metastatic and adjuvant settings in 2024, considering the latest published trials. The potential role of ICIs as neoadjuvants is also discussed.

Publisher

MDPI AG

Reference69 articles.

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