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Atezolizumab
Source: Bladder Cancer Treatment (PDQ®)–Health Professional Version, National Cancer Institute.
Source updated: May 2, 2025 · Captured 2026-09-09.
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Atezolizumab is a humanized monoclonal antibody that binds to PD-L1 and prevents it from binding to its receptors PD-1 or B7-1. Atezolizumab was voluntarily withdrawn in 2022 as a first-line treatment option for locally advanced or metastatic urothelial cancer. The withdrawal was based on the results of the randomized IMvigor130 trial (NCT02807636) which showed no significant difference in OS.[45][Level of evidence A1]; [46][Level of evidence A1] Atezolizumab has been studied as a second-line therapy after platinum-based chemotherapy.
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Evidence (atezolizumab):
The IMvigor211 trial (NCT02302807) is a randomized controlled trial that compared atezolizumab with second-line chemotherapy (docetaxel, paclitaxel, or vinflunine) in 931 patients with locally advanced or metastatic urothelial carcinoma who were previously treated with platinum-containing chemotherapy.[47] The trial design specified that OS would be primarily assessed in patients with PD-L1 expression of at least 5%.
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The IMvigor211 trial (NCT02302807) is a randomized controlled trial that compared atezolizumab with second-line chemotherapy (docetaxel, paclitaxel, or vinflunine) in 931 patients with locally advanced or metastatic urothelial carcinoma who were previously treated with platinum-containing chemotherapy.[47] The trial design specified that OS would be primarily assessed in patients with PD-L1 expression of at least 5%.
The median OS was 11.1 months for atezolizumab versus 10.6 months for chemotherapy in patients with PD-L1 expression of at least 5% (P = .41).[47][Level of evidence A1]
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The IMvigor211 trial (NCT02302807) is a randomized controlled trial that compared atezolizumab with second-line chemotherapy (docetaxel, paclitaxel, or vinflunine) in 931 patients with locally advanced or metastatic urothelial carcinoma who were previously treated with platinum-containing chemotherapy.[47] The trial design specified that OS would be primarily assessed in patients with PD-L1 expression of at least 5%.
Response rates were also similar: 23% with atezolizumab and 22% with chemotherapy.
The IMvigor211 trial (NCT02302807) is a randomized controlled trial that compared atezolizumab with second-line chemotherapy (docetaxel, paclitaxel, or vinflunine) in 931 patients with locally advanced or metastatic urothelial carcinoma who were previously treated with platinum-containing chemotherapy.[47] The trial design specified that OS would be primarily assessed in patients with PD-L1 expression of at least 5%.
Patients receiving atezolizumab had a lower rate of high-grade toxicity (20% vs. 43%) and a lower rate of treatment discontinuation resulting from adverse events (7% vs. 18%).
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Preserved source evidence · Not medical advice