PURPOSE OF REVIEW:Since 2016, five new programmed cell death protein 1/ligand 1 (PD-1/L1) checkpoint inhibitors have been approved for metastatic urothelial carcinoma. This review will summarize the data supporting the widespread use of these agents and highlight areas of ongoing clinical development. RECENT FINDINGS:PD-1/L1 axis inhibition has demonstrated clear superiority to chemotherapy for the treatment of metastatic urothelial cancer in the second-line setting. A multitude of ongoing studies are investigating the feasibility and efficacy of incorporating established and novel immunotherapies into earlier lines of therapy, including non-metastatic muscle-invasive bladder cancer and even non-muscle-invasive disease. Early-phase clinical trials have begun to explore the safety and activity of novel immune-oncology combinations across a range of clinical settings. Immunotherapy has a clearly defined role in the treatment of metastatic urothelial cancer both in the platinum-refractory setting and in the first-line cisplatin-ineligible setting. Ongoing clinical trials will dictate how to best incorporate immunotherapy into earlier lines of therapy and define the safety and activity of novel immunotherapy agents and combinations.

译文

审查目的:自2016年以来,已批准了五种新的程序性细胞死亡蛋白1 /配体1(PD-1 / L1)检查点抑制剂用于转移性尿路上皮癌。这篇综述将总结支持这些药物广泛使用的数据,并强调正在进行的临床开发领域。
最近的发现:在二线治疗中,PD-1 / L1轴抑制作用已显示出明显优于化疗的转移性尿路上皮癌。大量正在进行的研究正在研究将已建立的和新颖的免疫疗法纳入较早的治疗方法(包括非转移性肌肉浸润性膀胱癌,甚至非肌肉浸润性疾病)的可行性和有效性。早期临床试验已开始探索在一系列临床环境中新型免疫肿瘤组合的安全性和活性。免疫治疗在铂难治性和一线顺铂不适应性治疗中均具有明确定义的转移性尿路上皮癌治疗作用。正在进行的临床试验将决定如何将免疫疗法最佳地纳入早期疗法,并定义新型免疫疗法药物及其组合的安全性和活性。

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