Bladder Cancer Treatment (PDQ®)–Health Professional Version

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Changes to This Summary (11/16/2018)

The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.

Stage IV Bladder Cancer Treatment

Added text to state that there are currently four different immune checkpoint inhibitors approved; however, pembrolizumab is the agent with the highest level of evidence and the greatest data in terms of survival.

Added text to state that clinical trials have reported that atezolizumab acts against urothelial carcinoma, but it has not shown prolonged overall survival (OS) or improved quality of life. The only randomized controlled trial testing atezolizumab reported no significant difference in OS compared with second-line chemotherapy.

Added Powles et al. as reference 44 and level of evidence 1iiA.

Added text to state that response rates were 23% with atezolizumab and 22% with chemotherapy.

Added text to state that patients receiving atezolizumab had a lower rate of high-grade toxicity and a lower rate of treatment discontinuation resulting from adverse events.

Revised text to include a study of avelumab in 249 patients with metastatic urothelial carcinoma who had progressed after treatment with platinum-based chemotherapy (cited Patel et al. as reference 46).

Revised text to state that among the 161 patients with at least 6 months of follow-up, the overall response rate was 17%, and response was ongoing in 23 of 28 responders with a median follow-up of 7.3 months. Added that 6% of the patients had a complete response.

Added text to state that median progression-free survival (PFS) was 6.3 weeks; 23% of the patients were progression free at 24 weeks.

Recurrent Bladder Cancer Treatment

Added text to state that there are currently four different immune checkpoint inhibitors; however, pembrolizumab is the agent with the highest level of evidence and the greatest data in terms of survival.

Added text to state that clinical trials have reported that atezolizumab acts against urothelial carcinoma, but it has not shown prolonged OS or improved quality of life. The only randomized controlled trial testing atezolizumab reported no significant difference in OS compared with second-line chemotherapy.

Added Powles et al. as reference 22 and level of evidence 1iiA.

Added text to state that response rates were 23% with atezolizumab and 22% with chemotherapy.

Added text to state that patients receiving atezolizumab had a lower rate of high-grade toxicity and a lower rate of treatment discontinuation resulting from adverse events.

Added text to state that median PFS was 6.3 weeks; 23% of the patients were progression free at 24 weeks.

This summary is written and maintained by the PDQ Adult Treatment Editorial Board, which is editorially independent of NCI. The summary reflects an independent review of the literature and does not represent a policy statement of NCI or NIH. More information about summary policies and the role of the PDQ Editorial Boards in maintaining the PDQ summaries can be found on the About This PDQ Summary and PDQ® - NCI's Comprehensive Cancer Database pages.

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