Immunotherapy with newly developed “immune checkpoint inhibitors” has led to striking advances in treatment for aggressive malignancies such as melanoma, non-small cell lung cancer, and renal cell carcinoma. These novel therapeutics work by blocking the PD-1/PD-L1 pathway, which in turn helps reveal malignant cells to the immune system for subsequent eradication. Research is currently ongoing to see if patients with urothelial bladder cancer and renal impairment may better tolerate and benefit more from immunotherapy rather than chemotherapy, which remains the current standard of care.

References:

Kim J. Immune checkpoint blockade therapy for bladder cancer treatment. Investig Clin Urol. 2016;57 Suppl 1:S98-S105.

Rosenberg JE, Hoffman-Censits J, Powles T, et al. Atezolizumab in patients with locally advanced and metastatic urothelial carcinoma who have progressed following treatment with platinum-based chemotherapy: a single-arm, multicentre, phase 2 trial. Lancet. 2016;387(10031):1909-20.

Powles T, Eder JP, Fine GD, et al. MPDL3280A (anti-PD-L1) treatment leads to clinical activity in metastatic bladder cancer. Nature. 2014;515(7528):558-62.