Case 2: I-O Therapy for Cisplatin-Ineligible Bladder Cancer

EXPERT PERSPECTIVE VIRTUAL TUMOR BOARD

Arlene O. Siefker-Radtke, MD:How about any I/O [immunotherapy]-I/O combinations, anything that avoids the chemotherapy and potential toxicity?

Elizabeth R. Plimack, MD:I think there’s the DANUBE trial: durvalumab versus durvalumab and tremelimumab; eagerly awaited results we haven’t seen yet. So that question is being asked, again, typically with I/O-I/O combination, is the toxicity more challenging to manage? I think we learned that in renal cell and melanoma. And so again, we’re going to have to balance whatever the toxicity looks like compared to the response, durability of response. And really there I think we’d be looking for a long-term durability, which has been seen with I/O-I/O combos in other diseases.

Tian Zhang, MD:And the CheckMate 901 study is still ongoing. In fact, I think they just added some patient numbers to enrollment, so we still have that open at Duke Cancer Institute, and we’re still actively enrolling patients to that study. And so that’s IPI/NIVO [ipilimumab/nivolumab] and also [nivolumab]/chemotherapy versus chemotherapy. I think a lot to learn in this space.

Arlene O. Siefker-Radtke, MD:I think in the future we’ll be seeing a lot more about chemotherapy I/O combinations, I/O-I/O, antibody drug conjugates. There’s another one that I’ve been working on called bempegaldesleuken, which stimulates lymphocyte production using the IL-2 [interleukin-2] pathway combined with immunotherapy. So I think the community should know there are so many great options. We’d really appreciate referral of patients so we can get them these opportunities and hopefully find 1 that’s going to enhance this durability of response, that chemotherapy alone hasn’t really achieved.

Transcript edited for clarity.