Abstract：
CONCLUSIONS: In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.
OBJECTIVE: The activity of targeted and immunotherapy for the management of advanced bladder cancer is reviewed.
CONCLUSIONS: Platinum-based chemotherapy is standard first-line treatment for advanced bladder cancer. Pembrolizumab is approved alone as first-line therapy for patients who are ineligible for any platinum-based chemotherapy and with enfortumab for patients ineligible for cisplatin-based chemotherapy. Avelumab is approved for maintenance therapy in patients who have not progressed with first-line platinum-containing therapy. Pembrolizumab, avelumab, and nivolumab are approved second-line therapy in patients who experience progression during or after platinum-containing chemotherapy. Erdafitinib is indicated for advanced disease that has susceptible FGFR2 or FGFR3 genetic alterations and has progressed during or after treatment with at least one line of platinum-containing chemotherapy. Enfortumab vedotin and sacituzumab govitecan are antibody-drug conjugates. They are both approved for patients who have received anti-PD-L1 or anti-PD-1 therapy and treatment with platinum-containing chemotherapy. Enfortumab is also indicated for patients who are ineligible to receive cisplatin-based therapy and have received one or more prior lines of therapy.
CONCLUSIONS: Six targeted and immunotherapeutic agents have been approved for patients with advanced urothelial bladder cancer. They all have demonstrated activity in patients for whom disease has progressed during or after platinum-based therapy. Pembrolizumab, with and without enfortumab, has demonstrated first-line activity, and avelumab is a key maintenance therapy after first-line treatment. The results of additional clinical trials should provide evidence to establish the exact role in therapy of each agent in patients with advanced disease.
OBJECTIVE: The activity of targeted and immunotherapy for the management of advanced bladder cancer is reviewed.
CONCLUSIONS: Platinum-based chemotherapy is standard first-line treatment for advanced bladder cancer. Pembrolizumab is approved alone as first-line therapy for patients who are ineligible for any platinum-based chemotherapy and with enfortumab for patients ineligible for cisplatin-based chemotherapy. Avelumab is approved for maintenance therapy in patients who have not progressed with first-line platinum-containing therapy. Pembrolizumab, avelumab, and nivolumab are approved second-line therapy in patients who experience progression during or after platinum-containing chemotherapy. Erdafitinib is indicated for advanced disease that has susceptible FGFR2 or FGFR3 genetic alterations and has progressed during or after treatment with at least one line of platinum-containing chemotherapy. Enfortumab vedotin and sacituzumab govitecan are antibody-drug conjugates. They are both approved for patients who have received anti-PD-L1 or anti-PD-1 therapy and treatment with platinum-containing chemotherapy. Enfortumab is also indicated for patients who are ineligible to receive cisplatin-based therapy and have received one or more prior lines of therapy.
CONCLUSIONS: Six targeted and immunotherapeutic agents have been approved for patients with advanced urothelial bladder cancer. They all have demonstrated activity in patients for whom disease has progressed during or after platinum-based therapy. Pembrolizumab, with and without enfortumab, has demonstrated first-line activity, and avelumab is a key maintenance therapy after first-line treatment. The results of additional clinical trials should provide evidence to establish the exact role in therapy of each agent in patients with advanced disease.
摘要：
结论：为了加快文章的发表，AJHP在接受后尽快在线发布手稿。接受的手稿经过同行评审和复制编辑，但在技术格式化和作者打样之前在线发布。这些手稿不是记录的最终版本，将在以后替换为最终文章（按照AJHP样式格式化并由作者证明）。
目的：综述了靶向和免疫治疗治疗晚期膀胱癌的活性。
结论：以铂为基础的化疗是晚期膀胱癌的标准一线治疗。Pembrolizumab被批准单独作为一线治疗，用于不符合任何铂类化疗的患者，并与enfortummab一起用于不符合顺铂为基础的化疗的患者。Avelumab被批准用于一线含铂治疗未进展的患者的维持治疗。Pembrolizumab,阿维鲁单抗,在含铂化疗期间或之后出现进展的患者中,纳武单抗被批准为二线治疗.Erdafitinib适用于具有易感FGFR2或FGFR3遗传改变的晚期疾病，并且在用至少一种含铂化疗方案治疗期间或之后进展。Enfortumabvedotin和sacituzumabgovitecan是抗体-药物缀合物。它们都被批准用于接受抗PD-L1或抗PD-1治疗和含铂化疗治疗的患者。Enfortumab也适用于不适合接受基于顺铂的治疗且已接受一种或多种先前治疗的患者。
结论：六种靶向和免疫治疗药物已被批准用于晚期膀胱尿路上皮癌患者。它们都在基于铂的治疗期间或之后疾病进展的患者中表现出活性。Pembrolizumab,有和没有enfortumab，展示了一线活动，而阿维鲁单抗是一线治疗后的关键维持治疗.其他临床试验的结果应提供证据，以确定每种药物在晚期疾病患者治疗中的确切作用。
目的：综述了靶向和免疫治疗治疗晚期膀胱癌的活性。
结论：以铂为基础的化疗是晚期膀胱癌的标准一线治疗。Pembrolizumab被批准单独作为一线治疗，用于不符合任何铂类化疗的患者，并与enfortummab一起用于不符合顺铂为基础的化疗的患者。Avelumab被批准用于一线含铂治疗未进展的患者的维持治疗。Pembrolizumab,阿维鲁单抗,在含铂化疗期间或之后出现进展的患者中,纳武单抗被批准为二线治疗.Erdafitinib适用于具有易感FGFR2或FGFR3遗传改变的晚期疾病，并且在用至少一种含铂化疗方案治疗期间或之后进展。Enfortumabvedotin和sacituzumabgovitecan是抗体-药物缀合物。它们都被批准用于接受抗PD-L1或抗PD-1治疗和含铂化疗治疗的患者。Enfortumab也适用于不适合接受基于顺铂的治疗且已接受一种或多种先前治疗的患者。
结论：六种靶向和免疫治疗药物已被批准用于晚期膀胱尿路上皮癌患者。它们都在基于铂的治疗期间或之后疾病进展的患者中表现出活性。Pembrolizumab,有和没有enfortumab，展示了一线活动，而阿维鲁单抗是一线治疗后的关键维持治疗.其他临床试验的结果应提供证据，以确定每种药物在晚期疾病患者治疗中的确切作用。
