Reviewing the Options for Bladder Cancer in Different Settings

EP: 1.Nivolumab Shows Improved DFS in ITT and PD-L1–High Bladder Cancer

EP: 2.Surprising Findings With Nivolumab in Bladder Cancer Trials

EP: 3.Opinions on Treatment Split for Prominent Questions in Bladder Cancer

EP: 4.Differing Trial Designs for Immunotherapy in MIBC Yield Favorable Outcomes

EP: 5.Trials Needed for Sequencing Checkpoint Inhibitors in Bladder Cancer

EP: 6.IO Trials Change Practice in Localized and Metastatic Bladder Cancer

Now Viewing

EP: 7.Reviewing the Options for Bladder Cancer in Different Settings

Matthew R. Zibelman, MD, associate professor in the Department of Hematology/Oncology, director of Genitourinary Clinical Research, and director of Clinical and Translational Research, GU Service Line at Fox Chase Cancer Center, discusses treatment options in muscle-invasive, perioperative, and metastatic bladder cancer.

During a Case-Based Roundtable event, Zibelman and the event participants looked at the treatment of muscle-invasive bladder cancer. One of the highlights was the promising results of nivolumab (Opdivo) in the CheckMate 274 trial (NCT02632409) as adjuvant therapy. The group compared this with pembrolizumab (Keytruda) in the AMBASSADOR trial (NCT03244384), which Zibelman says turned out to be less effective in a similar population. Additionally, the potential of durvalumab (Imfinzi) in combination with chemotherapy in the NIAGARA trial (NCT03732677) was considered in perioperative bladder cancer.

In the metastatic setting, the efficacy of enfortumab vedotin (Padcev) in combination with pembrolizumab in the EV-302 trial (NCT04223856) was discussed in detail. These therapies showed significant benefits vs chemotherapy for first-line metastatic disease treatment, according to Zibelman, heavily impacting the approach for these patients.

TRANSCRIPTION:

0:10 | The discussion was focused first on the patients with muscle-invasive bladder cancer, and in that setting, we talked a lot about some of the new evidence for immunotherapy in the adjuvant setting, particularly with nivolumab and its benefits that was shown in the in the CheckMate 274 trial, as well as discussion of pembrolizumab in the AMBASSADOR trial, which did not show the same benefit. So, we really focused on the use of nivolumab in that set of patients.

0:40 | We also talked about new data from the NIAGARA trial, which talked about the addition of durvalumab to chemotherapy in a perioperative setting and discuss the potential role for that should that regimen become approved. Then finally, we talked a lot in the metastatic setting about the advent of enfortumab vedotin and its use with pembrolizumab for patients with first-line metastatic disease, and the exciting efficacy that we're seeing with that combination.