Types of Immunotherapy for Metastatic Bladder Cancer

Your immune system is designed to fight infection and diseases, including cancer. But cancer cells can grow unchecked because they avoid your body’s defenses.

Immunotherapy drugs work by making cancer cells easier targets or by boosting the immune system to make it more effective against the disease.

People with metastatic bladder cancer now have a few immunotherapy drugs for their disease, but scientists are working to find others.

Atezolizumab (Tecentriq)

This medicine is for the most common type of bladder cancer, urothelial carcinoma. It works by strengthening your body’s immune system response. It’s for people whose cancer has spread after they’ve had chemotherapy.

Atezolizumab is a type of immunotherapy drug called a checkpoint inhibitor. To keep your immune system from attacking normal cells, your body uses proteins called checkpoints. They help the immune system tell if other cells are a normal part of your body and should be left alone or invaders that should be attacked.

Cancer cells can trick your immune system by binding to the cells that are supposed to fight it. When that happens, the checkpoint signals your body not to attack. A checkpoint inhibitor stops these cells from binding. That way, your immune system recognizes and targets the cancer.

The FDA approved atezolizumab for metastatic bladder cancer after testing it on people whose cancers had gotten worse during or after chemotherapy.

  • About a quarter of the people in one study had tumors that got smaller.
  • In another trial, people had tumors stay smaller from 2 months to more than 13 months. For 84% of them, the drug was still working after a year.
  • Some people had their cancers disappear completely.

You take the drug once every 3 weeks by infusion, which means through a tube (an IV) that goes into a vein.                                         

One benefit of immunotherapy is it uses your body’s natural defenses. Once your immune system better recognizes cancer, it can continue to target those cells even if you’re treatment has ended.

Nivolumab (Opdivo)

Nivolumab is also for people with advanced urothelial carcinoma whose cancer has spread after they’ve tried chemotherapy. Like atezolizumab, it’s a checkpoint inhibitor drug.


You get it once every 2 weeks by infusion through an IV into your vein.

In one study of the drug:

  • Almost 20% of people had tumors that got smaller after treatment.
  • Some people had their tumors disappear completely.

Other Immunotherapies for Bladder Cancer

Researchers are now testing other potential immunotherapy drugs to see how well they work on their own and combined with other treatments.

Some of these medicines are other checkpoint inhibitors: pembrolizumab (Keytruda) and durvalumab.

Researchers are also testing combinations of immunotherapies. Early results showed that nivolumab combined with another drug, ipilimumab, worked in 26% to 38% of people who took them.

Researchers are also studying atezolizumab in combination with another check-point inhibitor called MTIG7192A.

WebMD Medical Reference Reviewed by Minesh Khatri, MD on February 9, 2017



National Cancer Institute: “FDA Approves New Immunotherapy Drug for Bladder Cancer,” “Immunotherapy.”

Memorial Sloan Kettering Cancer Center: “Immunotherapy,” “FDA Approves ‘Game Changer’ Immunotherapy Drug for Bladder Cancer,” “A Phase II Study Assessing Mediators of Response to Nivolumab and Ipilimumab Immunotherapy in Patients with Advanced Melanoma or Bladder Cancer,” A Phase I/IB Study of Immunotherapy with CPI-444 Alone and with Atezolizumab in Patients with Metastatic Solid Tumors.”

American Cancer Society: “FDA Approves New Immunotherapy Drug for Bladder Cancer,” “Immunotherapy for bladder cancer.”

The University of Texas MD Anderson Cancer Center: “Q&A Understanding Immunotherapy,” “Nivolumab immunotherapy helps patients with advanced bladder cancer,” “Immune checkpoint inhibitors shrink tumors in 26 to 38 percent of metastatic bladder cancer patients.”

American Society of Clinical Oncology: “Patients With Advanced Bladder Cancer Benefit From Anti-PD-L1 Immunotherapy.”

The Lancet: “Atezolizumab in patients with locally advanced and metastatic urothelial carcinoma who have progressed following treatment with platinum-based chemotherapy: a single-arm, multicentre, phase 2 trial.”

FDA: “Nivolumab for Treatment of Urothelial Carcinoma.”

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