Durvalumab (MEDI4736; anti-PD-L1 inhibitor): to shed light on the treatment of advanced urothelial bladder cancer patients refractory to systemic chemotherapy

For several decades, chemotherapy regimens for advanced urothelial cancer of the urinary bladder have not changed, and they include methotrexate, vinblastine, doxorubicin and cisplatin (MVAC) and gemcitabine and cisplatin (GC) with similar efficacy and relatively less toxicity (1). Moreover, there are a few second-line chemotherapeutic agents demonstrating substantial therapeutic responses in patients who are resistant to platinum-based treatments (2). Although the novel targeted agents may offer alternative therapeutic options, their efficacies are still limited and further investigations are needed (3). Recently, many researchers have shown great interest in the role of local and systemic immune responses, which interplay with cancer cells, as a novel therapeutic target (4).