Immune checkpoint inhibitors have greatly altered the treatment landscape for bladder cancer. Initially confined to advanced disease, the anti-PD-1 therapies Keytruda (Merck & Co.) and Opdivo (Bristol Myers Squibb) are now approved for earlier treatment settings. The approval of Bavencio (Merck KGaA / Pfizer) as maintenance therapy for first-line locally advanced or metastatic urothelial carcinoma highlights the expanded use of immune checkpoint inhibitors in all lines of therapy. The regulatory approval of the antibody-drug conjugates Padcev (Seagen / Astellas) and Trodelvy (Gilead) has diversified the treatment paradigm for advanced and metastatic disease. Several new therapies and combinations anticipated to be approved by 2031 will only intensify the competition in this market.
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