Histological Subtypes and Response to PD-1/PD-L1 Blockade in Advanced Urothelial Cancer: A Retrospective Study

A New Prognostic Model in Patients with Advanced Urothelial Carcinoma Treated with First-line Immune Checkpoint Inhibitors

“…Anti-PD-(L)1 ICIs also have a role in the first-line setting for cisplatin-unfit patients with high PD-L1 tumors or for platinum (cisplatin and carboplatin)-unfit patients [2]. However, outcomes for those with poor Eastern Cooperative Oncology Group (ECOG) performance status (PS) and treatment-resistant tumors remain poor [5,6]. More recently, erdafitinib, a fibroblast growth factor receptor (FGFR) inhibitor, and enfortumab vedotin, an antibody-drug conjugate against Nectin-4, both received accelerated FDA approval in treatment-refractory aUC [7,8].…”

Successful treatment of recurrent small cell carcinoma of urinary bladder with pembrolizumab

“…8 Two studies looked at the ORR of ICIs for patients with stage IV UC with neuronal subtypes including SCCB (Table 1). 12,13 One of them reported relatively high ORR to Atezolizumab. 12 The other case report showed reasonable response to pembrolizumab in a patient with chemotherapy refractory SCCB.…”

“…Recently, a phase II study (NCT03430895) planned to evaluate ICIs therapy in patients advanced non-pure UC including SCCB and will hopefully answer more questions regarding this novel therapeutic option. 19 13 Patients who received anti-PD-1 or PD-L1 for UC with neuroendcrine feature…”

Urothelial carcinoma: variant histology, molecular subtyping, and immunophenotyping significant for treatment outcomes

“…However, despite data suggesting the advantages of diagnosing histological variants, they may still be considered too immature for implementation as a standard therapy. [67][68][69] Interestingly, a KEYNOTE-045 study using pembrolizumab, an ICI, as second line therapy for platinum resistant UC, has shown that patients with histological variants exhibited better cancer specific survival, as well as overall survival, compared with patients with conventional UC. 70 The PURE01 study revealed that UC-SD and LEL variants displayed a high degree of response to neoadjuvant pembrolizumab treatment.…”

“…42 The efficacy of immunophenotyping is unknown owing to a lack of supporting data and evidence. 69 Thirdly, there are no distinctive criteria, especially for immunophenotypes; hence, the distribution and intensity of immune cells is judged subjectively. Thus, objective criteria that are predictive factors for ICIs are required.…”