The role of modern immunotherapy in metastatic urothelial cancer: mini review

Abstract

The approval of immune checkpoint inhibitors (ICIs) has changed the treatment landscape in many aspects of urothelial cancer (UC), in both non-muscle-invasive bladder cancer and muscle-invasive bladder cancer and has introduced the concept of long-term remission for some patients in the metastatic setting. Front-line chemotherapy remains superior at achieving initial control of disease compared to front-line immune therapy. However, long-term durable responses are limited by chemotherapy resistance. The maintenance approach, sequencing chemotherapy with ICIs, could be considered a best of both worlds approach, achieving initial control with chemotherapy, which is maintained in some individuals with avelumab. However, outcomes for patients with metastatic UC remain poor. There are three steps to improving outcomes for these patients; the first is to develop better drugs and combinations of therapies, the second is the development of novel biomarkers and techniques to better select patients for treatment, and the third area of development is to give the drugs in the most optimal setting.

Impacto do tratamento de carcinoma pulmonar de células escamosas com Durvalumabe

“…Powles e colaboradores (2021) mostraram que Durvalumabe teve uma taxa de resposta objetiva de 17,8% em pacientes com carcinoma urotelial localmente avançado ou metastático(JACKSON-SPENCE et al, 2022), e Zandberg 2019 descreveram que Durvalumabe teve uma taxa de resposta objetiva de 16,2% em pacientes com carcinoma de células escamosas recorrente ou metastático de cabeça e pescoço.Os artigos sugerem que o Durvalumab pode ser eficaz no tratamento do carcinoma de células escamosas do pulmão, mas as evidências são contraditórias. Enquanto Senan e oportunidade que investiga a eficácia de Durvalumabe mais metformina para carcinoma de células escamosas de cabeça e pescoço, que encontrou uma tendência para um aumento na proporção de respondedores patológicos no grupo que recebeu metformina.No geral, embora as evidências sejam contraditórias, esses artigos sugerem que o Durvalumabe pode ser eficaz no tratamento do carcinoma de células escamosas do…”