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Bladder Cancer Immunotherapy

Bladder cancer immunotherapy is a treatment designed to help the immune system recognize cancer cells and reactivate specific immune cells to target and attack them. The immune system normally detects and protects the body from foreign elements, including viruses, bacteria, and abnormal cells like cancer. However, cancer can evade immune detection. Immunotherapy is sometimes recommended for patients who cannot tolerate or do not benefit from traditional chemotherapy.

As a potential side effect, immunotherapy could cause the immune system to attack normal organs and tissue in the body. The most common type of immunotherapy used in bladder cancer is BCG (Bacillus Calmette-Guerin.  

During a recent Understanding Advanced/Metastatic Bladder Cancer webinar, Dr. Alicia Morgans, MD, MPH, of Dana Farber Cancer Institute provided a simple explanation of immunotherapy.

Intravesical Immunotherapy

Intravesical immunotherapy is a bladder cancer treatment that involves placing immunotherapy drugs directly into the bladder through a catheter. This localized approach allows the medication to come into direct contact with the bladder lining, stimulating the immune system to recognize and attack cancer cells more effectively.

BCG (Bacillus Calmette-Guerin)

BCG is instilled into the bladder. There are now a number of new immune checkpoint inhibitors targeting the PD-1 receptor pathway approved by the U.S. Food and Drug Administration (FDA) for certain people with a type of bladder cancer called locally advanced or metastatic urothelial carcinoma. Your doctor can help you determine if you might be a candidate for this treatment option.

Nadofaragene firadenovec (ADSTILADRIN®)

The novel gene therapy is administered directly into the bladder, or intravesically. It consists of a non-replicating virus that contains the gene to make interferon alfa-2b, an important immune system protein. The virus is mixed with a liquid and administered into the bladder where it targets the patient’s own bladder wall cells to enhance the body’s natural defenses to fight bladder cancer. The high local expression of interferon alfa-2b protein is typically sustained for 1 to 2 weeks and does not build into the patient’s DNA.

Nogapendekin alfa inbakicept (ANKTIVA®)

ANKTIVA® is the first U.S. FDA-approved immunotherapy that activates a type of cell called a natural killer (NK) cell, part of the body’s natural immune system, to attack and kill non-muscle invasive bladder cancer (NMIBC) cells.

Immune Checkpoint Inhibitors

Immune checkpoint inhibitors help boost the body’s immune response by helping immune cells to recognize and kill cancer cells. This helps the body to shrink or slow the growth of tumors, slowing the progression of the cancer.

Avelumab (Bavencio)

Avelumab is an immunotherapy drug used to treat certain cancers, including advanced or metastatic bladder cancer. It is a checkpoint inhibitor that works by blocking the PD-L1 protein, which some cancer cells use to evade detection by the immune system. By inhibiting PD-L1, avelumab helps the immune system recognize and attack cancer cells more effectively. It is often used as a maintenance therapy for patients who have responded to platinum-based chemotherapy.

How Does Immunotherapy Work? – Bladder Cancer Immunotherapy Animation

Peter H. O’Donnell, MD, from The University of Chicago, Section of Hematology/Oncology, explains immunotherapy as a bladder cancer treatment and addresses questions about how immune therapies work.

Side Effects of Immunotherapy for Bladder Cancer

Side effects of immunotherapy for bladder cancer include:

  • Flu-like symptoms
  • Fever
  • Chills
  • Fatigue
  • The urge to urinate
  • Painful urination
  • Symptoms of a urinary tract infection
  • Blood or clots in your urine 

Additional resources:

Download our “BCG Treatment” Fact Sheet 

This Get The Facts PDF provides you with what you should know before, during, and after BCG treatment.

In the “Immunotherapy for Treating Bladder Cancer” webinar series, Dr. Peter H. O’Donnell and patient advocates, Lynn Sperling and Andrew Kunz, discuss important topics about immunotherapy. 

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