Dr. Bupathi on the Evolving Treatment Landscape of Bladder Cancer

Manojkumar Bupathi, MD, MS, medical oncologist, Rocky Mountain Cancer Centers, discusses the evolving treatment landscape of bladder cancer.

Although unmet needs exist in bladder cancer, the integration of maintenance therapy has improved survival outcomes for patients, Bupathi says. However, it remains unknown why some patients do not derive sufficient responses to available therapy. As such, improved treatment options are needed for this patient subgroup.

Utilizing genomic analyses and targeted therapy is promising in this patient population, Bupathi explains. Recent data from ongoing clinical trials have also demonstrated promise. For example, during the 2021 ESMO Congress, findings from the phase 2 NORSE trial (NCT03473743) demonstrated clinically meaningful responses with erdafitinib (Balversa) plus cetrelimab in patients with FGFR-altered, metastatic or locally advanced urothelial carcinoma.

Findings from the ongoing phase 1/2 EV-103 trial (NCT03288545) demonstrated frontline activity with the antibody-drug conjugate enfortumab vedotin-ejfv (Padcev) in combination with pembrolizumab (Keytruda) in patients with locally advanced or metastatic urothelial carcinoma. Moreover, the combination of sEphB4-HSA and pembrolizumab demonstrated synergistic activity and tolerability in patients with previously treated metastatic bladder cancer, according to findings from an ongoing phase 2 trial (NCT02717156).

Investigational targeted therapies have also demonstrated encouraging efficacy in patients with bladder cancer. Ultimately, understanding the tumor biology of bladder cancer and identifying more specific targets will further advance this paradigm, Bupathi concludes.