Biological Therapeutic Advances for the Treatment of Advanced Urothelial Cancers

Abstract

In recent years, diagnostic and therapeutic advances have contributed to a reduction in mortality rates of patients with metastatic urothelial carcinoma (mUC). Immune checkpoint inhibitors have demonstrated efficacy and safety as both first-line and first-line switch maintenance therapy for mUC. For platinum-refractory patients, in addition to immunotherapy, other targeted agents (antibody–drug conjugates and fibroblast growth factor receptor inhibitors) have been approved after demonstrating a clinically relevant advantage in overall response rate, progression-free survival, and overall survival compared to standard of care. Sequential treatment strategies are finally feasible for patients with advanced urothelial carcinoma. This review will summarize the results of the most important phase II–III clinical trials for first-line, switch maintenance, second-line, and subsequent lines of therapy, and describe the most promising clinical trials currently ongoing in these treatment scenarios.

Keywords:

• metastatic urothelial carcinoma
• targeted therapy
• immune checkpoint inhibitors
• first-line treatment
• second-line treatment

Disclosure

MR acted as a paid consultant and/or speaker for Pfizer, Novartis, MSD and AstraZeneca. PG acted as a paid consultant and/or speaker for Astellas Pharma, Janssen and MSD, and received research funding from MSD, Astra Zeneca and Ipsen, and travel accommodation from Janssen. CP acted as a paid consultant and/or speaker for Angelini Pharma, AstraZeneca, BMS, Eisai, EUSA Pharma, General Electric, Ipsen, Janssen, Merck, MSD, Novartis and Pfizer, as an expert testimony for EUSA Pharma and Pfizer, as a Protocol Steering Committee Member for BMS, Eisai and EUSA Pharma, and received travel accommodation from Roche. The authors report no other conflicts of interest in this work.

Additional information

Funding

The authors have no funding or financial support to disclose.