Atezolizumab is currently in clinical development for the treatment of patients muscle-invasive urothelial cancer (MIUC) including muscle-invasive bladder cancer (MIBC) and upper tract urothelial cancer (UTUC) patients who are at high risk following resection. MIBC is a cancer that spreads into the thick muscle deep in the bladder wall. MIBC starts in the inner bladder layer and then grows in the deep muscle. While UTUC can arise along any part of the urinary tract lined with urothelium with the majority of cases in the lower tract and rest in the upper tract. Over time the tumour may grow outside the bladder into tissues close by and then may spread to lymph nodes, the lungs, the liver and other parts of the body. The current standard care of treatment includes a surgery which might not be adequate and some patients might be at high risk for recurrence.
Atezolizumab is a cancer medicine that is designed to recognise and attach to a protein called PD-L1, which is present in many cells. By attaching to PD-L1 and reducing its effects, atezolizumab increases the ability of the immune system to attack the cancer cells and thereby slow down progression of the disease. If licensed, atezolizumab will offer an adjuvant treatment for muscle-invasive urothelial carcinoma (MIUC) patients who are at high-risk for recurrence following resection.
Nivolumab in combination with ipilimumab is in clinical development for PD-L1 positive patients with previously untreated unresectable or metastatic urothelial cancer regardless of cisplatin eligibility. Urothelial cancer, a subset of bladder cancer, occurs on the lining of the renal pelvis, ureter, bladder and urethra, and other parts of the urinary system. In some cases,the tumour spreads into the surrounding muscles or other parts of the body which means that it cannot be cured by surgery. Metastatic urothelial cancer occurs when the cancer has spread to other parts of the body, such as the liver or bones. The symptom of urothelial cancer is blood in the urine, but symptoms may only appear once the cancer grows larger or into the deeper layers of the bladder wall for both men and women. Other symptoms may include increased frequency/urgency/pain of urine passing, weight loss, back/lower tummy/bone pain, fatigue and illness.