Immunotherapy for bladder cancer
Immunotherapy is designed to stimulate the body's defenses to attack and kill cancer cells. We use two primary types of immunotherapy to treat bladder cancer:
Checkpoint inhibitors work by targeting signaling proteins that allow cancer cells to hide from the immune system. They may also stimulate the immune system to better recognize and attack cancer cells. The U.S. Food and Drug Administration (FDA) has approved the checkpoint inhibitor drugs atezolizumab (Tecentriq®), nivolumab (Opdivo®), pembrolizumab (Keytruda®) and durvalumab (Imfinzi®) to treat bladder cancer. These drugs target the proteins PD-1 and/or PD-L1, key receptors that help to regulate immune response.
The FDA has also approved pembrolizumab to treat patients with inoperable metastatic tumors that have genetic features called microsatellite instability-high (MSI-H) or mismatch repair deficiency (dMMR). These features, which may prevent DNA in a cell to repair itself, may be found in some forms of bladder cancer.
Cancer vaccines are given to help prevent certain cancers, but they may also be used to treat bladder and other cancers by boosting the immune system. The Bacillus Calmette–Guérin (BCG) vaccine (Tice® or TheraCys®), originally developed for tuberculosis, is approved to treat bladder cancer. BCG is a live bacteria injected into the bladder that attracts immune cells, which then attack cancer cells.
Immunotherapy may not be recommended for all patients, and responses to the treatment may vary widely. Immunotherapy may also be used in combination with other treatments such as surgery or chemotherapy.