Bladder Cancer and Upper Tract Urothelial Carcinoma – Unmet Need – Detailed, Expanded Analysis: Unresectable Locally Advanced or Metastatic Bladder Cancer (US/EU)

The approvals of anti-PD-1/PD-L1 therapies—Keytruda (Merck & Co.), Opdivo (Bristol Myers Squibb), and Bavencio (Merck KGaA)—and antibody-drug conjugates—Padcev (Seagen / Astellas) and Trodelvy (Gilead)—have greatly altered the treatment landscape for bladder cancer in the last few years and markedly diversified the treatment armamentarium for locally advanced and metastatic disease. The approval of Balversa (Janssen Biotech) in the United States has provided an additional treatment option for the 15-20% of patients with susceptible FGFR alterations. However, given the dismal overall survival of patients with distant metastases and the lack of effective treatments for all patients, a significant level of unmet need remains in this indication.


  • How important are clinical drug attributes in medical oncologists’ prescribing decisions? What are the key influences on treatment decisions and the hidden opportunities that drug developers could leverage? What are the treatment drivers and goals in unresectable locally advanced or metastatic bladder cancer?
  • How do key current therapies, such as Keytruda, Bavencio, Opdivo, and Padcev, perform on key clinical drug attributes in this patient population? How satisfied are medical oncologists with current therapies?
  • What are the greatest unmet needs and most attractive opportunities in this patient population?
  • What trade-offs across different clinical attributes and price are acceptable to U.S. and European medical oncologists for a hypothetical new drug for unresectable locally advanced or metastatic bladder cancer?


Unmet Need supports clinical development decisions by identifying key attributes and assessing areas of unmet need for a specific disease or subpopulation. Based on surveys with U.S. and European physicians, this report provides insight into key treatment drivers and goals, the performance of current therapies, and the remaining commercial opportunities. One market scenario is profiled in detail by Clarivate experts, and additional customized market scenarios can be evaluated with the corresponding TPP Simulator.

Markets covered: United States, France, Germany, United Kingdom

Primary research: Survey of 61 U.S. and 30 European medical oncologists fielded in January 2023

Key companies: Merck & Co., Bristol Myers Squibb, Merck KGaA, Janssen Biotech, Seagen, Astellas, Gilead

Key drugs: Keytruda, Opdivo, Bavencio, Balversa, Padcev, Trodelvy

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