Nivolumab is in development for the treatment of a type of bladder cancer that is at high risk of spreading beyond the lining of the bladder into the surrounding muscle. Bladder cancer starts when cells that make up the urinary bladder start to grow out of control. As more cancer cells develop, they can form a tumour and, with time, spread to other parts of the body. Urothelial cancer is the most common type of bladder cancer. High risk invasive urothelial cancer is when there is a greater chance for the cancer cells spreading to the lymph glands around the bladder and therefore patients have a reduced chance of cure.
Nivolumab, is a monoclonal antibody, a type of protein that has been designed to recognise and attach to a receptor (target) called PD-1 found on certain cells of the immune system called T cells. Cancer cells can produce proteins (PD-L1 and PD-L2) that attach to this receptor and switch off the activity of the T cells, preventing them from attacking the cancer. By attaching to the receptor, nivolumab prevents PD-L1 and PD-L2 from switching off the T cells, thereby increasing the ability of the immune system to kill cancer cells. If licenced for the adjuvant treatment of high risk invasive urothelial carcinoma, nivolumab has the potential to increase the length of time until the cancer comes back.
Nivolumab in combination with cisplatin and fluorouracil is in clinical development for patients with unresectable, advanced, recurrent or metastatic oesophageal squamous cell cancer cell carcinoma. Advanced oesophageal cancer begins in the food pipe and spreads to other parts of the body. Squamous cell cancers develop from the cells that make up the inner lining of the oesophagus. Symptoms include difficulty swallowing, persistent acid indigestion or heartburn, weight loss, pain in the throat, and chronic cough. Lifestyle factors are attributed to most oesophageal cancers, including smoking and being overweight.