Surgical intervention, chemotherapeutic regimens, and radiation therapy have been the primary weapons in the frontline fight against cancer. However, immunotherapy, a fourth therapeutic modality, now holds the promise of a new age in the battle against even the most resistant cancers. Bladder cancer, in particular, has carried a poor prognosis in late-stage and metastatic disease. Current treatments have been inadequate with only minimal success. The discovery of checkpoint proteins, along with a better understanding of the role they play in tumor evasion mechanisms, has opened the door to mobilizing a significant immune response in patients with cancer. Using monoclonal antibodies (mAbs) to block the inhibitory signals of the programmed death-1 (PD-1)/ programmed death-ligand 1 (PD-L1) pathway has the potential to change traditional treatment pathways. This supplement will review the traditional treatments of bladder cancer, describe PD-1 and PD-L1 pathways, and present evidence from clinical trials evaluating the specific role of drugs targeting the PD-1 pathway in bladder cancer.
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