Bladder Cancer

According to results from the phase I JAVELIN Solid Tumor study recently published in the Lancet Oncology, the PD-L1 inhibitor avelumab (Bavencio) induced an overall response rate of 17% in patients with platinum-refractory metastatic urothelial carcinoma.

Pembrolizumab (Keytruda) has been approved in Japan for the treatment of patients with radically unresectable urothelial carcinoma who progressed after cancer chemotherapy, according to Merck, the manufacturer of the PD-1 inhibitor.

Arjun Balar, MD, discusses novel immunotherapy combinations for the treatment of patients with bladder cancer.

Chimeric antigen receptor T-cell therapy with bb2121 demonstrated an objective response rate of 94% in patients with&nbsp;relapsed/refractory multiple myeloma, according to findings from a dose-escalation study. The senior study author, James N. Kochenderfer, MD, presented updated findings from the study during the 2017 ASH Annual Meeting, and commented that 89% of patients had a very good partial response or better, and 56% of patients had a complete remission.&nbsp;<br /> &nbsp;

Matthew D. Galsky, MD, Professor of Medicine, Mount Sinai School of Medicine, discusses progression in patients with metastatic bladder cancer.

In an effort to improve bladder preservation and quality of life, investigators are currently exploring the efficacy of risk-adapted treatment for patients with muscle-invasive bladder cancer&nbsp;after receiving a neoadjuvant accelerated methotrexate, vinblastine, doxorubicin, and cisplatin (MVAC) regimen.

The use of atezolizumab (Tecentriq) is being recommended by the UK&#39;s National Institute for Health and Care Excellence (NICE) for treatment-na&iuml;ve patients with locally advanced or metastatic urothelial carcinoma who are not eligible for cisplatin-based therapy.

Combining the PD-1 inhibitor nivolumab (Opdivo) with the novel IDO inhibitor&nbsp;BMS-986205 generated promising response rates&nbsp;in patients with advanced cervical or bladder cancers and similar adverse effects to what is seen with anti&ndash;PD-1 monotherapy, according to findings of an early-phase clinical trial presented by Jason J. Luke, MD, during the&nbsp;SITC 32nd Annual Meeting.

Metastatic urothelial cancer is a relatively chemotherapy-sensitive malignancy. With contemporary cisplatin-based combination chemotherapy regimens, objective responses are achieved in approximately 50-60% of patients and complete radiographic responses are achieved in approximately 10-20% of patients.

For decades and even to this day, the foundation of metastatic bladder cancer therapy has been cytotoxic chemotherapy. In fact, until recently, the most significant breakthrough in treatment was in the 1980s, when cisplatin-based therapies, specifically MVAC, became the new standard of care.

In an interview, Jonathan E. Rosenberg, MD, discusses the guidelines and their significance for the treatment of patients with muscle-invasive bladder cancer.

A multidisciplinary set of guidelines for the treatment of patients with nonmetastatic muscle-invasive bladder cancer has been created as a result of a new collaboration between the American Urological Association and several other prominent urological groups.&nbsp;The new guidelines provide a risk-stratified clinical framework to better diagnose, treat, and manage the disease.&nbsp;

According to an update from the phase II KEYNOTE-052 trial presented at the 2017 Global Congress on Bladder Cancer, pembrolizumab (Keytruda) was safe and provided tumor reduction as well as durable responses as a first-line treatment for patients with&nbsp;cisplatin-ineligible advanced urothelial cancer.

The therapeutic landscape for patients with metastatic urothelial carcinoma is being rapidly altered by clinical trials of immunotherapy, but overall survival could be dramatically improved simply by changing the way quality of life is monitored,&nbsp;according to findings presented at the 2017 Global Congress on Bladder Cancer.

Patients with a history of non-muscle invasive bladder cancer may not have to undergo multiple cytoscopies during routine follow-up, according to data on a new procedure for monitoring RNA indicators of disease recurrence in urine samples.&nbsp;

Sumanta K. Pal, MD, medical oncologist, assistant clinical professor, Department of Medical Oncology and Therapeutics Research, City of Hope, discusses choosing second-line therapy for patients with urothelial carcinoma.

Andrea B. Apolo, MD, principal investigator and the head of the Bladder Cancer Section in the Genitourinary Malignancies Branch at the National Cancer Institute&rsquo;s Center for Cancer Research, discusses a phase I study of cabozantinib (Cabometyx) plus nivolumab (Opdivo) and cabozantinib plus nivolumab with ipilimumab (Yervoy) in patients with refractory metastatic urothelial carcinoma and other genitourinary tumors.

Adding ramucirumab to docetaxel improved progression-free survival (PFS) over docetaxel alone for patients with advanced or metastatic urothelial carcinoma who have progressed on platinum-based chemotherapy,&nbsp;results from the international phase III RANGE trial showed.

Pembrolizumab has been approved by the European Commission for the treatment of patients with locally advanced or metastatic urothelial carcinoma&nbsp;who have received prior platinum-containing chemotherapy, or who are not eligible for cisplatin-containing chemotherapy.

Median overall survival findings from treatment with pembrolizumab (Keytruda) were significantly longer compared with chemotherapy in patients with recurrent, advanced urothelial carcinoma, according to mature results from the phase III KEYNOTE-045 study.&nbsp;

Andrea Apolo, MD, medical oncologist at the National Cancer Institute and chief of the bladder cancer section of the Genitourinary Malignancies Branch, discusses the recent updates presented at the 2017 ESMO Annual Congress regarding avelumab (Bavencio) monotherapy for patients with urothelial carcinoma.&nbsp;

Jonathan E. Rosenberg, MD, discusses the muscle-invasive bladder cancer guidelines&nbsp;and their significance for the treatment of patients with muscle-invasive bladder cancer.

Thomas Flaig, MD, has been named chair of the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) Panel for Bladder Cancer.

Elizabeth Plimack, MD, chief of the division of genitourinary medical oncology and director of genitourinary research at Fox Chase Cancer Center in Philadelphia, discusses the combination of epacadostat and pembrolizumab (Keytruda) for the treatment of patients with urothelial carcinoma.

Jorge Garcia, MD, discusses how the field of bladder cancer has transformed with the FDA approval of pembrolizumab, and how oncologists should choose between 5 checkpoint inhibitors now available for the second-line setting and beyond.