Dr. Joshi on Rationale for Durvalumab/RT Combo in Localized Urothelial Carcinoma

Monika Joshi, MD, associate professor, Division of Hematology/Oncology, Penn State Hershey Medical Center, discusses the rationale for using durvalumab (Imfinzi) in combination with radiation therapy (RT) in patients with localized urothelial carcinoma.

The phase Ib DUART/BTCRC-GU15-023 study evaluated the safety of combining durvalumab with RT followed by adjuvant durvalumab in patients with urothelial carcinoma.

The trial enrolled patients who were either surgically unresectable, unfit for surgery, or cisplatin-ineligible, says Joshi. While the study included patients with localized disease, patients who were node positive with N1 or N2 disease were eligible for enrollment.

In 2017, the FDA approved durvalumab for the treatment of patients with locally advanced or metastatic urothelial carcinoma who have disease progression during or following platinum-containing chemotherapy, or whose disease has progressed within 12 months of receiving platinum-containing chemotherapy in the neoadjuvant or adjuvant setting.

RT is also a useful modality for patients with localized bladder cancer, says Joshi.

The goal of the study is to define newer treatment approaches for patients with nonmetastatic disease, concludes Joshi.