Immunotherapy for bladder cancer

The immune system protects the body against illness and infection. Immunotherapies are treatments that use the immune system to find and attack cancer cells.

A type of immunotherapy called a checkpoint inhibitor may be used to treat bladder cancer that has spread.

Checkpoint inhibitors are usually only used if:

• cisplatin chemotherapy is not suitable
• cisplatin chemotherapy is not working well
• the cancer comes back after chemotherapy.

Sometimes, they are given after chemotherapy to keep the cancer under control. This is called maintenance therapy.

Your cancer doctor will explain if a checkpoint inhibitor is a suitable treatment for you. Some drugs may only be available as part of a clinical trials.

Learn more about taking part in a cancer clinical trial.

Checkpoint inhibitors that are used to treat bladder cancer include:

• atezolizumab
• pembrolizumab
• avelumab
• nivolumab
• ipilimumab
• durvalumab
• tremelimumab.

Your cancer doctor will tell you if they think any of these drugs, or a drug not listed, is suitable for you.

A different type of immunotherapy called BCG treatment is used to treat non-muscle-invasive bladder cancer. This is cancer that is in the inner lining or the connective tissue that surrounds the inner lining of the bladder.

BCG is short for Bacillus Calmette Guérin. BCG treatment is given directly into the bladder (intravesical). It is used to treat high-risk non-muscle-invasive bladder cancer and sometimes intermediate-risk bladder cancer.

We have separate information about BCG treatment for bladder cancer.

New treatments are being developed for non-muscle-invasive bladder cancer. This includes immunotherapy into a vein (IV). This is only available as part of a clinical trial. Your doctor will give you more information about this if they think it may be useful for you.

Common side effects of checkpoint inhibitor drugs include:

• feeling tired
• skin changes
• diarrhoea
• feeling short of breath
• hormone problems.

Side effects may be mild, but sometimes they can become serious very quickly if they are not treated. Side effects can start weeks, months, or sometimes more than a year, after you finish treatment.

Your cancer doctor or nurse will give you information about managing side effects. It is important to tell them about any side effects you have, even after you have stopped having treatment.

Your doctor, nurse or pharmacist will also give you a card with information about your treatment on it. It is important to always have the card with you during treatment and after treatment finishes. You should show it to any doctor or healthcare professional you need to see.