Current and Upcoming Treatments Provide Options in Bladder Cancer

Neal D. Shore, MD, FACS, medical director and certified physician investigator at the Carolina Urologic Research Center, discusses the current treatment landscape and upcoming drugs being reviewed by the FDA for the treatment of patients with bladder cancer.

Pembrolizumab (Keytruda) was recently approved in 2020 for patients with persistent carcinoma in situ. The FDA will be reviewing 2 intravesical agents, nadofaragene firadenovec (Adstiladrin) and oportuzumab monatox (Vicinium) for potential approval in 2021.

Patients who suffer from high-risk non-muscle invasive bladder cancer and are unresponsive to Bacillus Calmette-Guerin only had the option of having their bladders removed before the approval of pembrolizumab, and hopefully 2 more in 2021, according to Shore.

Shore thinks that the current and upcoming options in this setting are extremely exciting. These options include systemic therapy for metastatic urothelial carcinoma in the bladder, new intravesical treatments for high-risk non-muscle invasive bladder cancer, studies looking at tri-modal bladder-sparing treatments combining neoadjuvant chemotherapy with radiation and immunotherapy, and even the role for immunotherapy checkpoint inhibitors as neoadjuvant strategies. This field continues to evolve at an exponential pace, he says.