Dr. Zhang on the IMvigor130 Trial in Metastatic Urothelial Cancer

Tian Zhang, MD, assistant professor of medicine, Duke University School of Medicine, and member, Duke Cancer Institute, discusses data from the randomized phase III IMvigor130 trial, which compared the safety and efficacy of atezolizumab (Tecentriq) in combination with platinum-based chemotherapy (arm A), atezolizumab monotherapy (arm B), and chemotherapy alone (arm C), in the frontline treatment of patients with metastatic urothelial cancer.

IMVigor130 is the first trial to combine a PD-L1 inhibitor with chemotherapy in this patient population, says Zhang.

In an interim analysis, the median OS with the combination was 16.0 months in the atezolizumab combination arm compared with 13.4 months in chemotherapy arm (HR 0.83; 95% CI 0.69-1.00; P = .027), and 15.7 months versus 13.1 months in arms B and C, respectively. Although the OS benefit observed was not statistically significant, a trend toward improvement was shown in patients treated with the combination, says Zhang.

Investigators also reported a trend for improved survival in patients with overexpression of PD-L1 who were treated with atezolizumab monotherapy compared with chemotherapy. These findings underscore the need to consider PD-L1 marker selection when choosing atezolizumab monotherapy, adds Zhang.

More mature OS data from IMvigor130 are anticipated, she concludes.