Enrique Grande, MD, discusses the characteristics of metastatic urothelial cancer, which rationalizes the use of atezolizumab in combination with platinum-based chemotherapy in the IMvigor130 trial, in patients with locally advanced or metastatic urothelial carcinoma.<br />
Enrique Grande, MD, medical oncologist, MD Anderson Cancer Center Madrid, discusses the characteristics of metastatic urothelial cancer, which rationalizes the use of atezolizumab (Tecentriq) in combination with platinum-based chemotherapy (PBC) in the IMvigor130 trial, in patients with locally advanced or metastatic urothelial carcinoma (mUC).
Higher mutation tumor grades are common in patients with mUC. With immunotherapy, these patients are more likely to respond to treatment because there are more neoantigens to stimulate the immune system, says Grande. When chemotherapy is added, activity in the immune system may be enhanced and, therefore, chemotherapy could potentially be synergistic with immunotherapy. This idea was the rationale for the study of atezolizumab plus PBC in one arm of the trial in addition to the other arms, atezolizumab alone, and chemotherapy plus placebo.
IMvigor130 was a positive study that showed a median progression-free survival (PFS) of 8.2 months in the atezolizumab plus PBC arm compared with 6.3 months in the PBC plus placebo arm (HR, 0.82; 95% CI, 0.70, 0.96;P