Dr. O'Donnell Compares Checkpoint Inhibitors in Bladder Cancer

Peter O’Donnell, MD, associate professor of medicine, University of Chicago Medicine, compares checkpoint inhibitors in the treatment of patients with bladder cancer.

Currently, immunotherapy agents can only be compared by extrapolation because there have not yet been head-to-head clinical trials in this space, O’Donnell says. In phase III clinical trials looking at the platinum-refractory setting, pembrolizumab (Keytruda) has shown a survival advantage against taxane-based chemotherapy. In the same comparison, atezolizumab (Tecentriq) did not show such benefit. As a result, O’Donnell says he finds himself using pembrolizumab because of its Level 1 designation in the platinum-refractory space. He concludes that more survival data are needed to fully distinguish between the available immunotherapies.

Both atezolizumab, a PD-L1 inhibitor, and pembrolizumab, a PD-1 inhibitor, are FDA approved for the frontline treatment of patients with metastatic urothelial carcinoma. The approvals were announced following the results of the IMvigor210 and KEYNOTE-052 studies.