Emerging targeted therapies in advanced bladder cancer

The prognosis of advanced urothelial bladder cancer (UBC) is dismal despite conventional platinum-based chemotherapy and, as such, new therapeutic agents are urgently needed. Recently, many novel molecular-targeted agents inhibiting immune checkpoints, VEGF/R, FGF/R, or EGF/R are being developed in clinical trials. Among them, immune checkpoint inhibitors (ICI) targeting the PD-1/PDL1 pathway have shown the most promising outcomes with durable clinical response and favorable safety profile. Agents targeting VEGF/R, FGF/R, or EGF/R pathways are still being investigated and are not providing clear clinical benefit yet. An appropriate selection of fit patients may be necessary for further clinical development of these agents. While we are still in the beginning of targeted therapy for advanced UBC, recent breakthroughs in ICI treatment and accumulating knowledge in molecular biology of UBC will provide a new horizon in the future treatment of UBC.