Dr. Balar on Improved Outlook in Metastatic Bladder Cancer

Arjun V. Balar, MD, assistant professor, Department of Medicine, director, Genitourinary Medical Oncology Program, NYU Langone's Perlmutter Cancer Center, discusses the improved outlook for patients with metastatic bladder cancer.

Five or 6 years ago, conversations with patients with metastatic bladder cancer were limited to platinum-based chemotherapy and, upon progression, single-agent chemotherapy or palliative care alone, Balar says. For second-line therapy, patients would often choose best supportive care because the chemotherapy was not likely to lead to meaningful responses, and certainly not a survival benefit.

Now, there are 7 FDA-approved indications for checkpoint inhibitors in metastatic bladder cancer: 2 in the frontline setting for platinum-ineligible patients and 5 in the second-line setting for platinum-refractory patients. In addition, a number of ongoing studies are testing novel compounds like antibody-drug conjugates and agents targeting FGFR3. Experimental immunotherapy compounds are also helping to reshape the way researchers view the disease, says Balar.