The Evolving Role of Checkpoint Inhibitors in the Treatment of Urothelial Carcinoma: A Literature Review of Practice-Changing Trials

Abstract

Traditional cisplatin-based chemotherapy has long been the mainstay treatment for advanced urothelial carcinoma (UC), but the emergence of immune checkpoint inhibitors (ICIs) and immunotherapy has revolutionized the field. ICIs, which target crucial immune proteins such as programmed cell death protein 1 (PD-1) and its ligand (PD-L1), enhance T-cell-mediated antitumor responses and have shown sustained responses not only in adjuvant settings but also in neoadjuvant and maintenance contexts. The introduction of newer agents like nivolumab and atezolizumab has broadened the use of ICIs, resulting in encouraging results in clinical trials for UC. This review offers a concise summary of key studies across various clinical stages and highlights ongoing clinical trials that could potentially impact UC treatment.