Antibody-Mediated Therapies in Urothelial Carcinoma: A Critical Narrative Review

Abstract

Simple Summary 1. Treatment outcomes for urothelial carcinoma have significantly improved recently due to advancements in antibody-based therapies, particularly immune checkpoint inhibitors (ICIs) and antibody-drug conjugates (ADCs). 2. ICIs enhance the patient’s immune response against cancer cells, whereas ADCs selectively deliver cytotoxic drugs to tumor cells expressing specific surface proteins such as Nectin-4, Trop-2, and HER2. 3. However, not all patients respond, and treatment resistance and toxicity remain significant challenges. 4. This review summarizes the mechanisms, clinical efficacy, biomarkers, and resistance mechanisms of antibody-mediated therapies in urothelial carcinoma, and discusses novel ADCs, combination strategies, and personalized treatment approaches that can improve sustained clinical outcomes.