Advanced bladder or urinary tract cancer, also known as metastatic urothelial cancer (MUC), occurs when abnormal cells of a muscle-invasive tumor spread beyond the bladder lining. The cancer may spread to the urethra or ureters or nearby organs like the prostate, uterus, vagina, or cervix. The FDA has approved KEYTRUDA® for the treatment of metastatic urothelial carcinoma in various situations. Before signing up for this treatment option, here are a few things to know.

Signs and symptoms
Metastatic urothelial cancer begins in the bladder and spreads to other parts of the body. If the cancer has spread, one might experience various signs and symptoms, such as back, stomach, or bone pain and fatigue. Other signs may include feeling generally unwell and noticing a sudden muscle mass reduction. One may experience unique symptoms based on where the cancer has spread. However, the symptoms can overlap with other health conditions, so one must be diagnosed before starting treatment. If MUC is detected, an oncologist may recommend KEYTRUDA® as a feasible treatment option.

Medication functionality
The immune system sends certain types of cells called T cells through the body to detect and fight infections or diseases, including cancer. However, cancerous cells use the PD-1 pathway to hide from the T cells, which prevents the immune system cells from attacking the cancer and letting them grow and spread. KEYTRUDA® is an immunotherapy that works with the immune system to fight various cancer types, including metastatic urothelial cancer. It blocks the PD-1 pathway to prevent the cells from hiding.

FDA-approved uses
KEYTRUDA® is a prescription option used to treat various types of cancers, including metastatic urothelial cancer. Here are some situations where the treatment options might be used for MUC:

– The prescription can be used with another monoclonal antibody (enfortumab vedotin) in adults when bladder or urinary tract cancer spreads or cannot be removed by surgery.

– KEYTRUDA® may be used by itself when the cancer has spread or cannot be removed by surgery. It may also be prescribed when one cannot receive chemotherapy that contains platinum.

– An expert may recommend the prescription when the cancer has spread or cannot be removed by surgery, such as in the case of metastatic urothelial cancer. The treatment will also be dependent on whether one has received chemotherapy that contains platinum but has not worked or no longer works.

– KEYTRUDA® might be the only option recommended when cancer has not spread to nearby tissues in the bladder but is at risk of metastasizing into high-risk non-muscle invasive bladder cancer (NMIBC) or carcinoma in situ (CIS). One’s treatment will also depend on whether one has been recommended a type of immunotherapy called Bacillus Calmette-Guerin (BCG).