Immunotherapy and Precision Medicine for Advanced Bladder Cancer

Immuno-oncology (or immunotherapy) and precision medicine are the newest developments in the treatment of advanced cancer. Immuno-oncology helps to restore the body’s immune system and improves outcomes when administered alone or in combination with chemotherapy.

There are several immuno-oncology treatments that work in advanced bladder cancer. PD-1 and PD-L1 inhibitors are collectively known as “checkpoint inhibitors”. Checkpoint inhibitors create their anti-cancer effect by blocking a specific protein used by cancer cells called PD-1 and PD-L1, to escape an attack by the immune system. Once PD-L1 is blocked, cells of the immune system are able to identify cancer cells as a threat and begin an attack to kill the cancer.

The goal of immunotherapy is to help the immune system recognize and eliminate cancer cells by either activating the immune system directly, or by inhibiting mechanisms of suppression of the cancer.

Immuno-oncology treatments approved for advanced bladder cancer:

  • Bavencio (avelumab)
  • Imfinzi (durvalumab)
  • Keytruda (pembrolizumab)
  • Opdivo (nivolumab)
  • Sotigalimab
  • Tecentriq (atezolizumab)


Precision cancer medicines use molecular testing, including DNA sequencing, to identify abnormalities in the cancer genome. Once a genetic abnormality is identified, a specific targeted therapy can be designed to attack a specific mutation or other cancer-related change in the DNA programming of the cancer cells.

Precision medicine approved for advanced bladder cancer:

  • Herceptin® (trastuzumab)
  • Padcev (Enfortumab Vedolin)
  • Trodelvy (Sacituzumab govitecan) (IMMU-132)


In an attempt to improve the chance of cure, immunotherapies are being tested alone or in combination with chemotherapy in clinical trials.