11 targeted drugs for the treatment of Bladder Cancer

There are several targeted drugs that are used for the treatment of bladder cancer. Some of the commonly used targeted drugs include:

Immune checkpoint inhibitors

Pembrolizumab and Atezolizumab are immune checkpoint inhibitors that are used to treat advanced bladder cancer that has spread to other parts of the body.

Pembrolizumab^[1]

Pembrolizumab: A monoclonal antibody that blocks the PD-1 immune checkpoint, restoring the ability of T-cells to detect and fight tumor cells. Used for patients with locally advanced or metastatic urothelial carcinoma who have disease progression during or following platinum-containing chemotherapy or within 12 months of neoadjuvant or adjuvant treatment with platinum-containing chemotherapy.

Nivolumab^[2]

Nivolumab: A monoclonal antibody that blocks the PD-1 immune checkpoint, restoring the ability of T-cells to detect and fight tumor cells. Used for patients with locally advanced or metastatic urothelial carcinoma who have disease progression during or following platinum-containing chemotherapy or have disease progression within 12 months of neoadjuvant or adjuvant treatment with platinum-containing chemotherapy.

Atezolizumab^[3]

Atezolizumab: A monoclonal antibody that targets PD-L1 and prevents it from binding to PD-1 and B7.1 receptors. Restores and enhances the immune response against bladder cancer cells. Used for patients with locally advanced or metastatic urothelial carcinoma who are not eligible for cisplatin-containing chemotherapy. 

Durvalumab^[4]

Durvalumab: A monoclonal antibody that blocks the PD-L1 immune checkpoint, restoring the ability of T-cells to detect and fight tumor cells. Used for patients with locally advanced or metastatic urothelial carcinoma who have disease progression during or following platinum-containing chemotherapy or have disease progression within 12 months of neoadjuvant or adjuvant treatment with platinum-containing chemotherapy.

Avelumab^[5]

Avelumab: A monoclonal antibody that targets PD-L1 and prevents it from binding to PD-1 and B7.1 receptors. Restores and enhances the immune response against bladder cancer cells. Used for patients with locally advanced or metastatic urothelial carcinoma who have disease progression during or following platinum-containing chemotherapy or have disease progression within 12 months of neoadjuvant or adjuvant treatment with platinum-containing chemotherapy.

Trodelvy（sacituzumab govitecan-hziy）^[6]

Trodelvy: An antibody-drug conjugate that targets Trop-2, which is highly expressed in bladder cancer cells. It binds to Trop-2 and delivers the chemotherapeutic drug SN-38 to kill cancer cells. Used for patients with locally advanced or metastatic urothelial cancer who have received a platinum-containing chemotherapy and either programmed death receptor-1 (PD-1) or programmed death-ligand 1 (PD-L1) inhibitor.

Padcev（enfortumab vedotin-ejfv）^[7]

Padcev: An antibody-drug conjugate that targets Nectin-4, which is highly expressed in bladder cancer cells. It binds to Nectin-4 and delivers the chemotherapeutic drug monomethyl auristatin E to kill cancer cells. Used for patients with locally advanced or metastatic urothelial cancer who have received a platinum-containing chemotherapy and either PD-1 or PD-L1 inhibitor.

FGFR inhibitors

EGFR inhibitors

Cetuximab^[9]

Cetuximab: A monoclonal antibody that targets the epidermal growth factor receptor (EGFR). It binds to EGFR and blocks its activation to inhibit the growth and spread of bladder cancer cells. Used for patients with metastatic bladder cancer in combination with cisplatin chemotherapy.

VEGF inhibitors

Ramucirumab^[10]

Ramucirumab: A monoclonal antibody that targets vascular endothelial growth factor receptor-2 (VEGFR-2). It binds to VEGFR-2 and blocks its activation to inhibit the growth of new blood vessels that feed bladder cancer cells. Used for patients with locally advanced or metastatic urothelial carcinoma in combination with docetaxel chemotherapy after platinum therapy has failed.

Gene Therapy

Adstiladrin（nadofaragene firadenovec）^[11]

Adstiladrin: An oncolytic virus that selectively replicates in and destroys bladder cancer cells. Used for patients with bacillus Calmette-Guerin (BCG)-refractory, high-grade, non-muscle invasive bladder cancer.

It is important to note that the choice of targeted drugs for the treatment of bladder cancer depends on various factors, such as the stage and grade of the cancer, the genetic mutations present in the cancer cells, and the patient's overall health status. Treatment decisions are best made in consultation with a healthcare professional.