Dr. Plimack on Choosing a Checkpoint Inhibitor in Bladder Cancer

Elizabeth Plimack, MD, director of Genitourinary Clinical Research at Fox Chase Cancer Center, discusses choosing a checkpoint inhibitor in bladder cancer.

2017 brought the approval of 5 checkpoint inhibitors across first- and second-line of bladder cancer—nivolumab (Opdivo), durvalumab (Imfinzi), avelumab (Bavencio), atezolizumab (Tecentriq), and pembrolizumab (Keytruda).

With a plethora of options, one of the challenges that clinicans face is determining which agent to use, Plimack explains. Although there is no concrete answer, Plimack says that the schedule of administration is a factor, as atezolizumab and pembrolizumab are given every 3 weeks, whereas the remaining 3 are given every 2 weeks.

Additionally, the positive phase III study of pembrolizumab might lead clinicians to choosing that option, Plimack says, but it should be noted that it performed similarly to atezolizumab in the phase III trial. The issues with the design of the atezolizumab trial led it to be negative, Plimack adds.