Reviewed by: HU Medical Review Board | Last reviewed: April 2023

Immunotherapy drugs are a type of treatment for patients with certain forms of bladder cancer, including some advanced bladder cancers. Bladder cancer generally starts to grow in the lining of the bladder, but in advanced bladder cancer, the cancer cells have spread into the muscle of the bladder wall and/or potentially into other organs and tissues near the bladder and in other parts of the body further from the bladder.1

Which immunotherapy drugs are approved to treat bladder cancer?

Immunotherapy drugs that are currently approved by the US Food and Drug Administration (FDA) to treat patients with certain forms of bladder cancer include:

For patients with certain forms of bladder cancer, including some advanced and metastatic bladder cancers, as well as specific other forms of bladder cancer, immunotherapy medicines are a potential treatment option. The exact use of immunotherapy in bladder cancer depends on the individual medication being utilized for treatment.

How do immunotherapy drugs work?

Immunotherapy drugs work by helping a patient’s immune system to more effectively target and attack cancer cells.2

The immune system is a group of organs and cells in the body that work together to protect the body. Special immune system cells—called T-cells—travel throughout the body seeking out and fighting diseases and infections, including cancer cells. Proteins called PD-1 and PD-L1 can help disguise cancer cells from the body’s T-cells and prevent the T-cells from attacking the cancer cells. This allows the cancer cells to multiply and spread more quickly than they would if the T-cells could detect them.

What are PD-1 and PD-L1 inhibitors?

The immunotherapy drugs, known as immune checkpoint inhibitors, approved for treating certain forms of bladder cancer consist of two categories of medications called PD-1 inhibitors and PD-L1 inhibitors. These drugs work by blocking the ability of either the PD-1 or PD-L1 proteins to hide the cancer cells from the body’s T-cells. This helps the T-cells to find and destroy cancer cells more effectively. In some patients, treatment with PD-1 or PD-L1 inhibitors can potentially help to reduce the size of their tumors or stop the tumors from growing as quickly.

Most immunotherapy drugs for treating bladder cancer are administered to the patient through an intravenous (IV) infusion once every two to six weeks, depending on the exact immunotherapy treatment.

What are the possible side effects of immunotherapy?

Because of the way that immunotherapy drugs for bladder cancer work, they can also cause some serious side effects. Immunotherapy drugs are systemic drugs that can affect the entire body, and they can cause the immune system’s T-cells to attack healthy cells, tissues, and organs as well as attacking cancer cells.1

Healthcare providers will talk with patients considering treatment with immunotherapy drugs about their advantages and disadvantages. Patients who have certain types of health conditions may not be able to receive immunotherapy drugs because of the serious side effects they can cause, such as:

  • Lung problems
  • Intestinal problems
  • Liver problems
  • Hormone gland problems
  • Kidney problems
  • Problems in other organs

Generally, women who are pregnant, planning to become pregnant, breastfeeding, or planning to breastfeed cannot receive these immunotherapy drugs. This is because the drugs can cause birth defects and other serious problems.

These are not all the possible side effects of immunotherapy drugs. Talk to your doctor about what to expect when taking these drugs. You also should call your doctor if you have any changes that concern you when taking immunotherapy drugs.

Before beginning treatment for bladder cancer, tell your doctor about all your health conditions and any other drugs, vitamins, or supplements you take. This includes over-the-counter drugs.

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