Dr. Packiam the Investigation of Cabazitaxel Plus Gemcitabine with Pembrolizumab in Urothelial Carcinoma

Vignesh Packiam, MD, urologist, assistant professor of Urology, University of Iowa Hospitals and Clinics, discusses the investigation of cabazitaxel (Jevtana) and gemcitabine with pembrolizumab (Keytruda) in patients who are unresponsive to docetaxel with non-muscle invasive urothelial carcinoma.

Gemcitabine plus docetaxel has become a more common option as a sequential intravesical regimen for this patient population, Packiam says. Moreover, some of the patients in this population still experience recurrence after gemcitabine/docetaxel due to developed resistance to docetaxel, Packiam explains. Previous data indicated cabazitaxel can salvage a response in patients that were previously unresponsive, Packiam adds.

Single-agent pembrolizumab is FDA approved for patients with locally advanced or metastatic urothelial carcinoma who are not eligible for any platinum-containing chemotherapy, though there are some concerns about a suboptimal long-term response rate with this treatment, Packiam continues. In patients with more advanced, treatment-refractory disease, it is hypothesized that adding pembrolizumab to cabazitaxel plus gemcitabine could improve responses and their duration, Packiam concludes.