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Updated Content (last reviewed 10/19/2024)
In accordance with the Institute of Medicine’s Standards for Developing Trustworthy Clinical Practice Guidelines (CPGs), SITC CPGs undergo periodic evaluation to assess if new evidence necessitates modifications to recommendations, treatment algorithms, or other guideline content. This is done through our “SITC Living Guidelines” rapid update protocols designed to ensure SITC’s CPGs are up-to-date with cutting-edge thinking and incorporate the leading expert guidance in cancer immunotherapy care – a vital service to treating clinicians and those along the whole cancer care continuum.
The information below provides an overview of updates to the "Society for Immunotherapy of Cancer (SITC) clinical practice guideline on immunotherapy for the treatment of urothelial cancer" published in Journal for ImmunoTherapy of Cancer (JITC).
Rapid Update v2.4 Summary
- The FDA granted accelerated approval of enfortumab vedotin in combination with pembrolizumab for the treatment of adult patients with locally advanced or metastatic urothelial cancer in December 2023.
- The FDA granted approval of nivolumab in combination with cisplatin and gemcitabine as first-line treatment of adult patients with unresectable or metastatic urothelial carcinoma in March 2024.
- Data have been reported indicating similar responses to ICI therapy regardless of FGFR3 mutation status for patients with metastatic urothelial cancer.
- The FDA granted approval of nogapendekin alfa inbakicept with BCG for adult patients with BCG-unreseponsive NMIBC with carcinoma in situ with or without papillary tumors in April 2024.
- The mUC immunotherapy treatment algorithm and the NMIBC immunotherapy treatment algorithm have each been updated from the original publication to reflect additional treatment recommendations based on FDA approvals and practice-changing data.
Rapid Update v2.3 Summary
- Based on the voluntary withdrawal by the manufacturer of the atezolizumab indication for the treatment of cisplatin- and platinum-ineligible patients with mUC, the Urothelial Cancer CPG has been updated in the "Diagnostic tests and biomarkers for urothelial cancer immunotherapy" and "Advanced/metastatic urothelial carcinoma" sections as well as within the mUC treatment algorithm.
- Based on the approval of nadofaragene firadenovec for the treatment of BCG-unresponsive NMIBC with CIS with or without papillary tumors, the Urothelial Cancer CPG has been updated in the "Non-muscle invasive bladder cancer section" including the NMIBC treatment algorithm.
- Based on the approval of Enfortumab vedotin with pembrolizumab for the treatment of patients with locally advanced or metastatic Urothelial Carcinoma who are ineligible for cisplatin-containing chemotherapy, the Urothelial Cancer CPG has been updated in the "Advanced/metastatic Urothelial Carcinoma" section and the mUC treatment algorithm.
Rapid Update v2.2 Summary
- Based on the indication change for pembrolizumab for the treatment of patients with mUC, the Urothelial Cancer CPG has been updated in the following locations: "Immunotherapies for First-line Treatment of mUC" and the mUC treatment algorithm.
Rapid Update v2.1 Summary
- Based on the approval of nivolumab for the treatment of patients with urothelial cancer who are at high risk of recurrence after undergoing radical resection, the Urothelial Cancer CPG has been updated in the following locations: "Phase III trials of adjuvant therapy for MIBC," "Immunotherapy with chemoradiation as bladder-sparing therapy," "mUC treatment algorithm," "Immunotherapies for first-line treatment of mUC," and "Immunotherapies for R/R mUC."