Immunotherapy in Bladder and Renal Cancers Publisher



Khalili N¹ ; Khalili N¹ ; Rezaei N^{2, 3, 4} Show Affiliations
Source: Cancer Immunology: Cancer Immunotherapy for Organ-Specific Tumors Published:2020

Abstract

In the first section of this chapter, after providing a brief overview of the epidemiology of bladder cancer in the world, we discuss various immunotherapies used for treatment in both non-muscle invasive and muscle-invasive bladder cancer (NMIBC and MIBC). Perhaps the most well-known immunotherapy used for bladder cancer is intravesical BCG immunotherapy, which remains to be the standard treatment in intermediate-and high-risk NMIBC. However, regarding the substantial percentage of patients who fail to respond to BCG immunotherapy or patients whose disease relapses after an initial response to therapy, other immunotherapy approaches such as checkpoint inhibitors, vaccine therapy, gene therapy, and combination therapies have been investigated in this scope. Also, in respect to the growing number of patients who are unfit for cisplatin-containing chemotherapy, immune checkpoint inhibitors have been approved for first-or second-line treatment in patients with MIBC. The second part of this chapter focuses on immunotherapy in kidney cancer. Kidney cancer is the 14th most commonly diagnosed cancer worldwide. Over the last 10 years, the rates for kidney and renal pelvis cancer have been rising an average of 0.6% each year. Although patients with early, localized disease have an excellent prognosis with a 5-year cancer-specific survival rate of more than 90%, approximately 20% of patients present with metastases at diagnosis, and 25-40% experience recurrence after primary treatment. Previous treatment modalities such as chemo-and radiotherapy had not been successful for metastatic RCC yielding low overall response rates. However, discovery of the immune responsiveness of kidney cancer provided an opportunity for the development of immunomodulatory agents. With the introduction of combination strategies with an immunotherapy backbone, the first-line treatment landscape for metastatic RCC is rapidly changing. Immunotherapy has also showed promising results for patients at high risk of recurrence after surgical resection of localized cancer. © Springer Nature Switzerland AG 2020. All rights reserved.