Checkpoint inhibition in bladder cancer: Clinical expectations, current evidence, and proposal of future strategies based on a tumor-specific immunobiological approach.
    
    
        
    
    
        
        Cancers 13:6016 (2021)
    
    
    
		
		
			
				In contrast with other strategies, immunotherapy is the only treatment aimed at empowering the immune system to increase the response against tumor growth. Immunotherapy has a role in the treatment of bladder cancer (BC) due to these tumors' high tumor mutational burden (TMB) and mostly prominent immune infiltrate. The therapy or combination has to be adjusted to the tumor's immunobiology. Recently, a new class of immunotherapeutic agents, immune checkpoint inhibitors (ICI), has shown potential in increasing treatment chances for patients with genitourinary cancers, improving their oncological outcomes. The clinical efficacy of ICI has been shown in both the first-line treatment of cisplatin-ineligible patients, with programmed death ligand 1 (PD-L1)-positive tumors (atezolizumab, pembrolizumab), and in second-line settings, for progression after platinum-based chemotherapy (atezolizumab, pembrolizumab, and nivolumab for FDA and EMA; durvalumab and avelumab for FDA alone). Predicting the response to ICI is important since only a subset of patients undergoing ICI therapy develop a concrete and lasting response. Most of the patients require a different therapy or therapy combination to achieve tumor control. The cancer immunity cycle provides a conceptual framework to assist therapy selection. Biomarkers to predict response to ICI must identify where the cancer immunity cycle is disrupted. We reviewed the current knowledge on ICI treatment in BC, going from basic science to current data and available clinical evidence. Secondly, a critical analysis of published data is provided, and an original panel of biomarkers able to predict response to ICI treatment, based on tumor-specific immune profiling, is proposed.
			
			
				
			
		 
		
			
				
					
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        Publikationstyp
        Artikel: Journalartikel
    
 
    
        Dokumenttyp
        Review
    
 
    
        Typ der Hochschulschrift
        
    
 
    
        Herausgeber
        
    
    
        Schlagwörter
        Bcg Failure ; Bladder Cancer ; Cancer Immunoprofiling ; Checkpoint Inhibition ; Immunotherapy Biomarkers ; Randomized Clinical Trials ; Urological Research; Metastatic Urothelial Carcinoma; Cisplatin-ineligible Patients; Cd4(+) T-cells; Single-arm; Infiltrating Lymphocytes; Neoadjuvant Chemotherapy; Pd-l1 Blockade; Solid Tumors; Open-label; Pembrolizumab
    
 
    
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        englisch
    
 
    
        Veröffentlichungsjahr
        2021
    
 
    
        Prepublished im Jahr 
        
    
 
    
        HGF-Berichtsjahr
        2021
    
 
    
    
        ISSN (print) / ISBN
        2072-6694
    
 
    
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	    Band: 13,  
	    Heft: 23,  
	    Seiten: ,  
	    Artikelnummer: 6016 
	    Supplement: ,  
	
    
 
  
        
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            Verlag
            MDPI
        
 
        
            Verlagsort
            St Alban-anlage 66, Ch-4052 Basel, Switzerland
        
 
	
        
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        Peer reviewed
    
 
     
    
        POF Topic(s)
        30203 - Molecular Targets and Therapies
    
 
    
        Forschungsfeld(er)
        Immune Response and Infection
    
 
    
        PSP-Element(e)
        G-502710-001
    
 
    
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        Erfassungsdatum
        2022-01-25