Historically, advanced bladder cancer has been harder to treat. In recent years, a new class of immunotherapy drugs called checkpoint inhibitors has emerged, offering hope to patients with metastatic disease. “Immune checkpoint blockade really provided an alternative for those patients. And it was the first drug to be approved for use in metastatic bladder cancer in over 30 to 40 years,” says Dr. Roger Li, a urologic oncologist at the Moffitt Cancer Center in Tampa. “So it gave the medical oncologist as well as the urologist a new tool to treat our patients and also gave some of our patients hope to be put on those different agents after they progressed on chemotherapy.”
However, only 15-25% of patients will actually see a response regardless of when they were put on these drugs in their treatment plan, according to Dr. Li. Why do the majority of patients not respond to checkpoint inhibitors? He says one reason is that checkpoint inhibitors may need an immune response already in progress in order to work. “For those tumors that can’t generate an immune response, (checkpoint inhibitors) really don’t have a role to play in those tumors.” In addition, Dr. Li believes that in some patients, cytokines or molecules that are produced in the tumor may be inhibiting the action of the immunotherapy. Research is underway to investigate how more patients can benefit. “Here at Moffitt and other cancer sites, we are actively investigating into new strategies where we’re using still the immune checkpoint blockers as a backbone, but adding on to them different combination treatments.”
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