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What are immunotherapy drugs for bladder cancer?

Immunotherapy drugs are a new type of treatment for patients with advanced bladder cancer.1 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.

Immunotherapy drugs that are currently approved by the U.S. Food and Drug Administration (FDA) to treat patients with advanced bladder cancer include:

These drugs are generally only prescribed for patients with advanced bladder cancer who cannot receive chemotherapy, or who have already tried treatment with systemic chemotherapy, but the chemotherapy did not work or stopped working.

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.

As of 2019, the five immunotherapy drugs approved for treating advanced bladder cancer are comprised of drugs 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 or three weeks, depending on the exact immunotherapy treatment.

What are the possible side effects?

Because of the way that immunotherapy drugs for bladder cancer work, they can also cause some serious side effects.1 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. 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, or breastfeeding cannot receive these immunotherapy drugs due to the risk of birth defects and other serious problems.

Written by Anna Nicholson | Last review date: July 2019.
  1. Gupta S, Gill D, Poole A, Agarwal N. Systemic Immunotherapy for Urothelial Cancer: Current Trends and Future Directions. Golubovskaya V, ed. Cancers. 2017;9(2):15. doi:10.3390/cancers9020015.
  2. How Keytruda Works. Accessed September 2017.