Facing treatment of non-urothelial bladder cancers in the immunotherapy era

Crit Rev Oncol Hematol. 2020 Sep:153:103034. doi: 10.1016/j.critrevonc.2020.103034. Epub 2020 Jun 20.


Non-urothelial Bladder Cancer (BC) and variants of urothelial carcinoma account for up to 25 % of all BCs. Given their heterogeneity, these entities are not well represented in clinical trials and treatment remains challenging. Checkpoint inhibitor therapy has shown a role in the treatment of urothelial BC. By contrast, robust evidence regarding its use in other histological types is lacking. We aimed to provide a comprehensive update of non-urothelial and variant urothelial BC, exploring the evidence for immune checkpoint inhibitor therapy. A detailed analysis of the literature was conducted regarding epidemiology, aetiology, diagnosis, prognosis, treatment and outcomes of these patients in the immunotherapy era. A growing body of evidence suggests that immune checkpoint inhibition might have a role to play in non-urothelial BC, similarly to what happened with urothelial carcinomas.

Keywords: Bladder adenocarcinoma; Checkpoint inhibitors; Immunotherapy; Non-urothelial bladder cancer; Squamous cell bladder cancer; Variant urothelial cancer.

Publication types

  • Review

MeSH terms

  • Carcinoma, Transitional Cell*
  • Humans
  • Immunologic Factors
  • Immunotherapy
  • Urinary Bladder Neoplasms / therapy*
  • Urologic Neoplasms*


  • Immunologic Factors