Are there new treatments for my recurrent urothelial cancer?

Question

Hello doctor,

I was diagnosed with urothelial cancer last year and had surgery, but now there are new spots in the bladder wall again. My urologist is talking about immunotherapy, but I also read about new antibody treatments.

• Can you explain what the most recent options are for this cancer?

• I am worried because chemotherapy did not work well for me last time. Do newer treatments help stop recurrence better?

• What side effects should I expect from these?

• Is there genetic testing that helps pick better treatment for urothelial cancer?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Treatments often depend on whether the recurrence happens soon after treatment or later. If the cancer comes back twelve months or more after treatment, it is called a late recurrence.

You may be offered immunotherapy for a locally advanced recurrence. An immune checkpoint inhibitor is an immunotherapy drug that may be used if the cancer comes back within twelve months of completing chemotherapy that includes Cisplatin.

The immune checkpoint inhibitors that may be used are:

Pembrolizumab.
Durvalumab.
Avelumab.
Monoclonal antibodies.
Enfortumab vedotin is a type of monoclonal antibody.

You may be offered Enfortumab vedotin if you have recurrent bladder cancer that has already been treated with Cisplatin or Carboplatin and a programmed death 1 or programmed death ligand 1 immune checkpoint inhibitor. It may also be a treatment option if you cannot be treated with Cisplatin or Carboplatin.

Genetic therapy for recurrent bladder cancer is not effective in your case (as there is invasion of the bladder wall). The probable diagnosis in your case is recurrent bladder cancer.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.