Immunotherapy for metastatic urothelial carcinoma

status quo and the future

Andrea Necchi, Michael Rink, Patrizia Giannatempo, Daniele Raggi, Evanguelos Xylinas

Research output: Contribution to journalReview article

Abstract

PURPOSE OF REVIEW: The treatment paradigm of urothelial carcinoma has been revolutionized by the advent of multiple anti-programmed-cell death-1/ligand-1 (PD-1/PD-L1) antibodies. Significant improvements have been obtained in the locally advanced or metastatic stage, which was lacking of therapeutic standards. This review reports key findings from completed and ongoing clinical trials that highlight the potential of PD-1/PD-L1 blockade in this disease.

RECENT FINDINGS: Anti-PD-1/PD-L1 monoclonal antibodies have shown efficacy and safety in patients with urothelial carcinoma, regardless of their prognostic features. Efficacy was similar across different compounds, with objective responses that approximate 20%, with some differences favoring PD-L1-expressing patients. Typically, responding patients have good chances of achieving durable response, but biomarkers predictive of therapeutic effect are lacking. To date, evidences from randomized studies are limited to the second-line, postplatinum therapy.

SUMMARY: Despite the activity of PD-1/PD-L1 inhibitors is well established in metastatic urothelial carcinoma, multiple gray zones still exist regarding their optimal use in clinical practice. These uncertainties are related to patient and treatment-related criteria, to the optimal duration of treatment, including combination or sequence with standard chemotherapy. Special issues are represented by pseudoprogression or hyperprogression. Generally, enhanced predictive tools are needed and a myriad of further investigations are underway.

Original languageEnglish
Pages (from-to)1-7
Number of pages7
JournalCurrent Opinion in Urology
Volume28
Issue number1
DOIs
Publication statusPublished - Jan 2018

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Immunotherapy
Carcinoma
CD274 Antigen
Therapeutics
Therapeutic Uses
Patient Safety
Uncertainty
Biomarkers
Monoclonal Antibodies
Clinical Trials
Drug Therapy
Antibodies

Keywords

  • Antineoplastic Agents, Immunological/therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols/therapeutic use
  • B7-H1 Antigen/antagonists & inhibitors
  • Carcinoma, Transitional Cell/drug therapy
  • Humans
  • Immunotherapy/methods
  • Neoplasm Staging
  • Prognosis
  • Programmed Cell Death 1 Receptor/antagonists & inhibitors
  • Salvage Therapy/methods
  • Treatment Outcome
  • Urologic Neoplasms/drug therapy

Cite this

Immunotherapy for metastatic urothelial carcinoma : status quo and the future. / Necchi, Andrea; Rink, Michael; Giannatempo, Patrizia; Raggi, Daniele; Xylinas, Evanguelos.

In: Current Opinion in Urology, Vol. 28, No. 1, 01.2018, p. 1-7.

Research output: Contribution to journalReview article

Necchi, Andrea ; Rink, Michael ; Giannatempo, Patrizia ; Raggi, Daniele ; Xylinas, Evanguelos. / Immunotherapy for metastatic urothelial carcinoma : status quo and the future. In: Current Opinion in Urology. 2018 ; Vol. 28, No. 1. pp. 1-7.
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