Dr. Sonpavde on Emerging Immunotherapy Approaches in Bladder Cancer

Guru P. Sonpavde, MD, director, Bladder Cancer, and physician, Dana-Farber Cancer Institute, discusses emerging immunotherapy approaches in bladder cancer.

Data from several confirmatory phase III trials with FGFR inhibitors are eagerly anticipated in the bladder cancer space. Furthermore, immunotherapy is under investigation—specifically, looking at PD-1/PD-L1 inhibitors as adjuvant therapy after radical cystectomy to improve cure rates. Perhaps more exciting, says Sonpavde, is neoadjuvant therapy. Phase III trials combining platinum-based chemotherapy plus PD-1/PD-L1 inhibition are ongoing. There are also trials that are being planned in the setting of cisplatin ineligibility in the neoadjuvant space, an area of great unmet need. Right now, the standard of care in this setting is radical cystectomy.

In the neoadjuvant space, several phase II trials evaluating pembrolizumab (Keytruda) or atezolizumab (Tecentriq) alone look promising. Data from those trials showed pathologic complete responses ranging from 30% to 40%, says Sonpavde. Based on these data, phase III trials are being planned to assess the activity of these agents in a larger cohort of patients.