Evolution of immunotherapy in the treatment of non-muscle-invasive bladder cancer.

Emerging insights over the last decade have led to the development of novel immunotherapiesfor the treatment of NMIBC whilst providing new opportunities to enhance the anti-tumour activity of BCG. In particular, the KEYNOTE-057 trial represents a pivotal moment for immunotherapy in NMIBC, leading to approval of pembrolizumab by the US Food & Drug Administration for patients with BCG-unresponsive disease. However, patient selection and the development of biomarkers to guide the identification of patients who will benefit most from a particular immunotherapy remains critical. As research efforts come to fruition, these novel immunotherapies may become integrated into the standard treatment paradigm for intermediate- and high-risk NMBIC.