Immunotherapy Advances in Urothelial Carcinoma
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Checkpoint inhibitors have monumentally transformed the treatment of metastatic urothelial carcinoma. While the efficacy and safety of the different agents are similar in platinum-refractory metastatic urothelial carcinoma, pembrolizumab is the only agent that was superior to chemotherapy in a randomized phase III trial. Pembrolizumab and atezolizumab are also approved as first-line therapies in cisplatin-ineligible metastatic urothelial carcinoma. Several immunotherapy trials are ongoing in non-metastatic setting to maximize responses upfront. Despite the promising responses with immunotherapy, majority of patients do not respond to monotherapy and combination approaches would be the path moving forward to maximize responses. In addition, novel therapies are needed for patients who progress on checkpoint inhibitors. There is still a lot to be done to better understand predictive biomarkers, optimal combination, and sequences to improve clinical outcomes in urothelial carcinoma.
KeywordsUrothelial carcinoma Immunotherapy Biomarkers Checkpoint inhibitors
Compliance with Ethical Standards
Conflict of Interest
Rohit Jain declares that he has no conflict of interest.
Travis Snyders declares that he has no conflict of interest.
Lakshminarayanan Nandagopal declares that he has no conflict of interest.
Rohan Garje declares that he has no conflict of interest.
Yousef Zakharia has received compensation for participating on advisory boards for Pfizer, Novartis, Roche Diagnostics, Castle Biosciences, Exelixis, Eisai, Johnson & Johnson, and Amgen.
Shilpa Gupta has received research funding (paid to her institution) from Bristol-Myers Squibb; has received compensation for service on advisory boards from Exelixis, Janssen, ARMO, AstraZeneca, Merck, and Genentech; and has received compensation for service on speakers’ bureaus from Exelixis, Janssen, AstraZeneca, and Genentech.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
References and Recommended Reading
Papers of particular interest, published recently, have been highlighted as: • Of importance•• Of major importance
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