Matthew Galsky, MD

Matthew Galsky, MD, professor of medicine, director of Genitourinary Medical Oncology, director of the Novel Therapeutics Unit, and codirector of the Center of Excellence for Bladder Cancer at The Tisch Cancer Institute and the Icahn School of Medicine at Mount Sinai, discusses the most recent data in patients with bladder cancer.

Galsky says that it has been a busy time for drug development in the bladder cancer setting. Within the last year, multiple large clinical trials have announced their data for these patients in hopes of changing practice for the frontline treatment of patients with metastatic urothelial cancer.

There was the first read out of the IMvigor130 trial (NCT02807636), which combined platinum-based chemotherapy and the immune checkpoint blockade atezolizumab (Tecentriq) versus atezolizumab monotherapy or chemotherapy and placebo. This study showed an improvement in progression-free survival with the combination, and the overall survival demonstrated a numerical improvement, although it has not reached significance yet, according to Galsky.

The KEYNOTE-361 study (NCT02853305) tested the combination of chemotherapy and pembrolizumab (Keytruda) compared with chemotherapy alone or pembrolizumab alone. Galsky says that based on a press release, this trial did not meet its primary end point, which was disappointing.

At the 2020 American Society of Clinical Oncology Annual Virtual Scientific Meeting plenary session, JAVELIN Bladder 100 trial (NCT02603432) results were presented. In patients who have stable disease after receiving platinum chemotherapy in the first line, investigators looked at maintenance with avelumab (Bavencio) versus the best supportive care, which Galsky explains is observation in this setting. The data showed a significant improvement in progression-free survival and the overall survival with avelumab and this study is likely to change the standard of care.

<< For more about the JAVELIN Bladder 100 trial, click here

Videos

Matthew Galsky, MD, discusses the most recent data in patients with bladder cancer.

Discussing Recent Advances and Clinical Trials in Bladder Cancer

Matthew Galsky, MD, director, Genitourinary Medical Oncology, The Tisch Cancer Institute, Mount Sinai Hospital, discusses how the phase II HCRN GU14-182 study helps to define the role of switch maintenance therapy in patients with urothelial cancer. The study looked at maintenance with pembrolizumab (Keytruda) versus placebo following frontline chemotherapy in patients with metastatic urothelial cancer.

In a few randomized phase III studies, immune checkpoint blockade has already been integrated as a switch maintenance strategy following chemotherapy. Responses seen in these trials could be due to the immune checkpoint inhibitor, the chemotherapy, or the combination, says Galsky. The HCRN GU14-182 study helps define what maintenance may provide for this patient population, but this is still not an &ldquo;apples to apples&rdquo; comparison.

As researchers continue to look at combination maintenance approaches, Galsky says it is important to step back and consider what they hope to achieve in this setting. The hope of using immune checkpoint blockade is to improve or maintain responses. At the same time, patients can have a break from the toxicities of chemotherapy.

Matthew Galsky, MD, discusses how the phase II HCRN GU14-182 study helps to define the role of switch maintenance therapy in patients with urothelial cancer. The study looked at maintenance with pembrolizumab versus placebo following frontline chemotherapy in patients with metastatic urothelial cancer.

Phase II Trial Considers the Benefit of Switch Maintenance in Urothelial Cancer

Matthew Galsky, MD, professor of Medicine at the Mount Sinai School of Medicine, discusses results of a study examining nivolumab monotherapy in metastatic bladder cancer.

Results of a Study Examining Nivolumab in Metastatic Bladder Cancer

Matthew Galsky, MD, professor of Medicine, Mount Sinai School of Medicine, discusses the significant findings in, and the rationale behind conducting the CheckMate-275 trial during an interview at the 2016 ESMO Congress.

Matthew Galsky, MD | Authors

Articles

Discussing Recent Advances and Clinical Trials in Bladder Cancer

Phase II Trial Considers the Benefit of Switch Maintenance in Urothelial Cancer

Results of a Study Examining Nivolumab in Metastatic Bladder Cancer

The Rationale Behind CheckMate-275 in Metastatic Bladder Cancer