Dual checkpoint-blockade in urothelial carcinoma—when is it so far

Single agent immunotherapy is routinely used in the treatment of localised and advanced bladder cancer. Dual checkpoint inhibition with nivolumab (nivo)–ipilimumab (ipi) and durvalumab (durva)–tremelimumab (treme) shows encouraging activity in phase I/II trials in the neoadjuvant and metastatic disease setting. Several large trials are testing these combinations against the current standard of care. The so far reported results are negative; however, it appears that a subgroup of patients might profit substantially from dual checkpoint blockade. Ongoing trials will elucidate which patients will be candidates for this treatment modality in routine clinical care.