Bladder Cancer

An upcoming FDA decision for the PD-L1 inhibitor atezolizumab as a treatment for patients with bladder cancer could set the stage for an onslaught of new and highly effective immuno-oncology agents, according to Daniel Petrylak, MD.

A recent study has shown that extracting cell-free DNA from urine is a highly effective technique for analyzing the genetic profile of urothelial bladder cancers.

The PD-L1 inhibitor atezolizumab has gained priority review status from the FDA as a treatment for patients with locally advanced or metastatic urothelial carcinoma (mUC).

Immune checkpoint inhibitors have shown promising findings for patients with advanced bladder cancer, with data from phase II studies submitted to the FDA for consideration. The next question facing oncologists is how to optimally utilize these agents, according to James L. Gulley, MD, PhD.

Hoffman-Censits says atezolizumab has recently undergone a phase II clinical trial for patients with bladder cancer who failed platinum-based chemotherapy.

Siefker-Radtke says her preferred mathod of neoadjuvant chemotherapy is doxorubicin plus ifosfamide with an alternating regimen of etoposide cisplatin.

The FDA has granted a breakthrough therapy designation to durvalumab as a treatment for patients with PD-L1 positive inoperable or metastatic urothelial bladder cancer following progression on prior treatment with a platinum-based regimen.

Gulley says there is no standard procedure for the third line setting in bladder cancer, and that most oncologists would either turn to single-agent chemotherapy or to clinical trials.

Adjuvant chemotherapy was associated with improved overall survival (OS) compared with observation postcystectomy in patients with pathologic T3/4 and/or pathologic node-positive bladder cancer, according to a retrospective analysis published in the Journal of Clinical Oncology.

Single-dose fosaprepitant dimeglumine (Emend for injection) in combination with antiemetic agents has been approved by the FDA for the preventing

The FDA issued a complete response letter to Telesta Therapeutics informing the company that its biologics license application (BLA) for MCNA in bladder cancer would not be approved and that an additional phase III clinical trial was needed to adequately evaluate the immunotherapy.

A study published in Scientific Reports by researchers from China indicates panurothelial carcinoma (panUCC) has a high risk of recurring, progressing, and disseminating after conservative surgery, leading to poor outcomes.

Bladder cancer remains the costliest cancer to treat per capita, taking into account diagnostic testing, management, and long-term follow-up. Continued development of urine-based biomarker diagnostic tests may help replace the costly and more invasive techniques of imaging, cytology, and cystoscopy for cancer detection. Genome-wide expression and sequencing studies have identified genes and pathways considered key drivers of bladder cancer.

Urothelial bladder cancers (UBC) may display complex and heterogeneous features, driven in part by a diverse genomic profile.

Plimack says the efficacy of PD-L1 inhibitors have been proven in the treatment of bladder cancer and are currently employed in the armamentarium of medical professionals. She adds as other cancer types further test both ipilimumab and PD-L1 inhibitors, oncologists will gain a better understanding of how both will continue to play a role in bladder cancer.

Hoffman-Censits says outside of the first-line therapy of cisplatin-based chemotherapy in locally advanced unresectable bladder cancer tumors, there are currently no solutions for disease progression.

Padmanee Sharma discusses the constantly shifting landscape of immune response and how it differs from patient to patient. Sharma says in order to best treat a patient with bladder cancer, oncologists have to consider that immune response in patients will never be the same day to day.

Gulley says there are currently a variety of phase III studies looking at new treatments for use in bladder cancer, despite some widely-used agents, such as nivolumab and pembrolizumab, already being approved for other cancer types like melanoma and lung cancer, though not bladder cancer.

While results from ongoing trials with atezolizumab, pembrolizumab, nivolumab, and avelumab in bladder cancer are eagerly awaited, there is one subset of patients who require special attention - patients with upper tract urothelial cancer (UTUC).

A data metaanalysis supports the potential correlation between NAT2 slow acetylation and the risk of bladder cancer.

A high number of clinically relevant genomic alterations (CRGAs) were found in patients with advanced urothelial carcinoma (UC) using a comprehensive genomic profile (CGP).

Daniel P. Petrylak, MD, talks about taking the clinical trials examining MPDL3280A a step further for bladder cancer patients.

An FDA panel voted against approval of the immunotherapy MCNA as a treatment for patients with high-risk non-muscle invasive bladder cancer (NMIBC) following first-line bacillus Calmette-Guerin (BCG) therapy.

Select medical centers nationwide are now offering blue-light cystoscopy imaging to better detect papillary cancer of the bladder.

Bladder cancer may soon catch up to other areas of oncology in terms of an influx of immunotherapies, according to Thomas Powles, MD.