Petros Grivas, MD, PhD

Petros Grivas, MD, PhD, physician, Seattle Cancer Care Alliance; associate professor, Department of Medicine, Division of Oncology, and clinical director, Genitourinary Cancers Program, University of Washington School of Medicine; and associate member, Clinical Research Division, Fred Hutchinson Cancer Center, discusses the phase 3 KEYNOTE-045 trial and the association between gene expression signatures and pembrolizumab (Keytruda) in patients with advanced urothelial cancer.

All the patients receiving pembrolizumab on the KEYNOTE-045 trial appeared to benefit in terms of progression-free survival and overall survival, according to Grivas. There are no biomarkers with clinical utility that can guide selection of which patients should get pembrolizumab or not, based on the data presented the 2020 European Society for Medical Oncology. Therefore, these data show no impact on practice when using pembrolizumab to treat patients with platinum-refractory disease.

Grivas says that the utilization of pembrolizumab based on potential biomarkers needs to be researched further to evaluate the clinical advantage of gene expression signatures. At the moment, patients with platinum-refractory advanced urothelial cancer are all treated able to be treated with pembrolizumab.

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Petros Grivas, MD, PhD, discusses the phase 3 KEYNOTE-045 trial and the association between gene expression signatures and pembrolizumab in patients with advanced urothelial cancer.

Further Research Required to Find Biomarkers for Urothelial Cancer

Petros Grivas, MD, PhD, associate professor in the Division of Medical Oncology and clinical director of the Genitourinary Cancers Program at the University of Washington School of Medicine, discusses the JAVELIN Bladder 100 trial of maintenance avelumab (Bavencio) plus best supportive care versus best supportive care alone after platinum-based first-line chemotherapy in patients with advanced urothelial carcinoma.

This phase 3 trial demonstrated a statistically and clinically significant difference with a prolongation of overall survival (OS) for patients receiving avelumab plus best supportive care compared with best supportive care alone. In patients with avelumab plus best supportive care, the median OS was over 21 months and about 14 months in patients with best supportive care alone, which is a big difference compared to what is usually seen in oncology, according to Grivas. He says this made more statistical rigor with an impressive hazard ratio of 0.69, which suggest patients getting avelumab plus best supportive care will live longer.

Grivas says patients do not need to be checked for any biomarkers in this setting, such as PD-L1, since the OS benefit was seen in all-comers.

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Petros Grivas, MD, PhD, discusses the JAVELIN Bladder 100 trial of maintenance avelumab plus best supportive care versus best supportive care alone after platinum-based first-line chemotherapy in patients with advanced urothelial carcinoma.

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Further Research Required to Find Biomarkers for Urothelial Cancer

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