Evolving Considerations in the Treatment of Metastatic Bladder Cancer: A Closer Look at the Role of Immunotherapy

A continuing medical education activity sponsored by NAMCP and AAMCN.

This activity is an archive from the live session from the 2019 Spring Managed Care Forum. If you participated in the live session, you are not eligible for continuing education credits from this archive.

This activity is valid from July 10, 2019 to August 1, 2020

Instructions for CME/CNE: Complete the pre-test, listen to the audio and view the slides, complete the post test, complete the evaluation form and hit submit. You will be asked to enter your name and email address on the pre-test, evaluation and post-test. If you close your internet browser without completing the post test, you will have ONE more opportunity to complete. A score of 70% must be achieved on the post test to receive continuing education credits. If you do not pass the post test after two attempts, you will not be eligible to try again. Once you complete the evaluation form and score 70% or higher on your post test, you will automatically be given your certificate.

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Audience: This activity is intended for healthcare professionals practicing in managed care environments.

This presentation is supported by educational grants from
AstraZeneca LP and Merck Sharp & Dohme Corp.

Bladder cancer, also known as urothelial carcinoma, is the ninth leading cause of cancer death in the United States. Before the advent of new treatments in recent years, the basic management of this illness has remained unchanged for decades. Long-term survival for people diagnosed with advanced bladder cancer is poor, with approximately 5% of patients with metastatic bladder cancer surviving for 5 years or more. New and emerging treatments, in particular, immune checkpoint inhibitors such as programmed death-1 (PD-1), PD-ligand 1 (PD-L1), and cytotoxic T lymphocyte–associated antigen 4 (CTLA-4) inhibitors have changed the treatment paradigm. Checkpoint inhibitors have shown activity in patients with metastatic bladder cancer in both the second line setting and the first-line settings. Some of the new immunotherapeutic options target a protein known as PD-L1 that is expressed at high levels on some cancer cells, while others target PD-1, the receptor protein for PD-L1, on immune cells. Normally, binding of PD-L1 to PD-1 tamps down immune activity. By preventing the interaction between PD-L1 and PD-1, all of these new options can allow the immune system to be more active against tumor cells. 

Upon completion of this activity, participants will be able to:

  • Describe the underlying concepts of cancer immunotherapy, including systemic immune checkpoint blockade, and rationale for its use in bladder cancer

  • Examine the current status of checkpoint inhibitor use in bladder cancer at various stages of disease presentation and progression

  • Explore the role of sequential therapy and multimodal and/or combination regimens involving checkpoint inhibitors

  • Identify patients who would potentially benefit from immunotherapies in metastatic bladder cancer

  • Discuss strategies to prevent, anticipate, and manage immune-related adverse events (irAEs) in patients with metastatic bladder cancer

  • Assess the role of checkpoint inhibitors in the first-line treatment of metastatic bladder cancer

Faculty: Peter H. O’Donnell, MD
Associate Professor, Department of Medicine
Section of Hematology/Oncology
Genitourinary Oncology Program
The University of Chicago


Dr. O'Donnell serves on an advisory board for Astellas, AstraZeneca, Genentech, Inovio, Janssen, Merck, Parexel, Quintiles and Seattle Genetics. He has received research/grant support from Acerta, AstraZeneca/Medimmune, Boehringer Ingelheim, Bristol-Myers Squibb, Genentech, Janssen, Merck and Seattle Genetics. His presentation has been peer reviewed for any bias.
  Planning Committee:
Bill Williams, MD has no relevant financial relationships to disclose.
Jeremy Williams has no relevant financial relationships to disclose.
Will Williams has no relevant financial relationships to disclose.
Jacqueline Cole, RN, MS, CMCN has no relevant financial relationships to disclose.

NAMCP and/or the presenter has copyright or has received permissions for use of materials provided in this activity.

Accreditation & Designation
The National Association of Managed Care Physicians (NAMCP) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

NAMCP designates this enduring material for a maximum of 1 AMA PRA Category I creditsTM.

The American Association of Managed Care Nurses (AAMCN) is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation (ANCC).

Nurses who complete this activity and achieve a passing score will receive 1 hour in continuing
nursing credit.

This activity has been approved by the American Board of Managed Care Nursing for 1.0 contact hour toward CMCN recertification requirements.

This presentation is supported by educational grants from
AstraZeneca LP and Merck Sharp & Dohme Corp.

NAMCP and/or this website does not provide medical advice, diagnosis or treatment. NAMCP does not endorse or imply endorsement of the content on any linked website. This website is to be used as an informational resource. With any health related concern, consult with your physician or healthcare professional.

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