Dr. Joshi on Durvalumab/RT Combo in Locally Advanced Urothelial Cancer

Monika Joshi, MD, associate professor, Division of Hematology/Oncology, Penn State Hershey Medical Center, discusses durvalumab (Imfinzi) and radiation therapy (DUART) in locally advanced urothelial cancer of the bladder.

This type of regimen has been studied in the preclinical setting, as well as the clinical setting. For example, the PACIFIC study treated patients with stage III non—small cell lung cancer with durvalumab following concurrent chemoradiation. This trial inspired the phase I/II DUART/BTCRC-GU15-023 study in patients with urothelial cancer of the bladder, Joshi explains.

Radiation primes the immune system and causes more DNA damage to cancer cells. It also causes an increase in antigen presentation, which leads to a pro-inflammatory environment. When immunotherapy and radiation therapy are combined, the hypothesis of the study was that this environment would increase response rates and patients would have improved clinical outcomes, concludes Joshi.