J Korean Med Assoc.  2021 May;64(5):349-357. 10.5124/jkma.2021.64.5.349.

Treatment of advanced urogenital cancers with immune checkpoint inhibitors

Affiliations
  • 1Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea

Abstract

The development of immune checkpoint inhibitors has improved the long-term survival of patients with several types of cancers, including bladder and renal cell carcinomas. Atezolizumab, an anti-programmed death-ligand 1 monoclonal antibody, became the first immune checkpoint inhibitor to receive the US Food and Drug Administration approval for the treatment of advanced bladder cancer in 2016. Four additional immune checkpoint inhibitors have shown a durable efficacy and have been approved for the treatment of metastatic bladder cancers with progressive disease after treatment with platinum-containing chemotherapy. Currently, trials are exploring the effectiveness of these immune checkpoint inhibitors for first-line or perioperative cancer treatments. The treatment paradigm for advanced and metastatic renal cell carcinomas has also evolved rapidly since the introduction of immune checkpoint inhibitors. Various combinations with immune checkpoint inhibitors, such as nivolumab plus ipilimumab and pembrolizumab plus axitinib, have shown better efficacy than the treatment with sunitinib as first-line treatment for metastatic renal cell carcinoma. The challenges include the development of biomarkers to guide the selection of optimal patients to receive the therapies, the optimization of the sequences of immune checkpoint inhibitors, and the determination of more effective combinations with immune checkpoint inhibitors.

Keyword

Urogenital neoplasms; Urinary bladder neoplasms; Renal cell carcinoma; Immune checkpoint inhibitors; Immunotherapy; 비뇨생식기암; 방광암; 신세포암종; 면역관문억제제; 면역치료
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