Dr. Sonpavde on Neoadjuvant Immunotherapy in Bladder Cancer

Guru P. Sonpavde, MD, director, Bladder Cancer, and physician, Dana-Farber Cancer Institute, discusses current neoadjuvant immunotherapy options in bladder cancer based on cisplatin-eligibility status.

Checkpoint inhibitors pembrolizumab (Keytruda) and atezolizumab (Tecentriq), as single agents, have demonstrated activity in the neoadjuvant setting with pathologic complete response (pCR) rates of 30% to 40%.

For cisplatin-eligible patients, phase III trials are underway exploring these agents in combination with platinum-based chemotherapy. Pembrolizumab in combination with gemcitabine, for example, reported a pCR rate of approximately 45%, says Sonpavde.

Conversely, immunotherapy alone is being explored for cisplatin-ineligible patients compared with standard cystectomy, says Sonpavde.