Dr. Balar on Impact of Durvalumab Plus Tremelimumab in Bladder Cancer

Arjun V. Balar, MD, assistant professor, Department of Medicine, director, Genitourinary Medical Oncology Program, NYU Langone’s Perlmutter Cancer Center, discusses the impact of the combination of durvalumab (Imfinzi) plus tremelimumab in metastatic bladder cancer.

The addition of tremelimumab to durvalumab showed an overall response rate of 20.8% at a median follow-up of 11.6 months in this patient population. Balar says that there is clear evidence for activity with this combination as a treatment for patients with advanced bladder cancer. The response rate for single-agent durvalumab in Study 1108 was about 17.8%. Balar says that it is important to consider that in this study, patients with low levels of PD-L1 expression had a response rate of 5%.

Patients whose tumors were considered to have PD-L1—high expression had a response rate of 29% and those who had a low PD-L1 expression had a response rate of 15% when treated with the combination. These data suggest that that patients with low levels of PD-L1 may derive benefit from the addition of tremelimumab to durvalumab. Balar says that this still needs to be tested in a larger randomized prospective study, but it does provide early evidence supporting the addition of tremelimumab to durvalumab for patients with metastatic bladder cancer.