Atezolizumab for Bladder Cancer
Atezolizumab is an antibody targeting PD-L1, a component of the PD-1/PD-L1 immune checkpoint. When atezolizumab attaches to PD-L1 on the surface of tumor cells, it prevents it from interacting with PD-1 receptors on immune cells and thus unleashes the immune system to attack the tumor.
IMvigor210 is the first trial to test the efficacy of atezolizumab as the initial treatment in patients with advanced bladder cancer. These data are encouraging, and the researchers are planning a randomized phase III trial of atezolizumab as an upfront treatment for advanced bladder cancer.
A randomized clinical trial of atezolizumab as an adjuvant treatment for early-stage bladder cancer is also underway. Meanwhile, there are several ongoing clinical trials exploring other immune checkpoint inhibitors, including nivolumab, durvalumab, and pembrolizumab, in localized and advanced bladder cancer.
About Bladder Cancer
Bladder cancer is the fifth most common cancer in adults. Nearly 77,000 people will be diagnosed with bladder cancer in the United States this year,2 and 450,000 were diagnosed worldwide in 2012.3 Bladder cancer is largely a disease of the elderly; the average age at diagnosis is 70 years. This cancer is also closely linked to smoking, with 80% of patients being former smokers.
The standard upfront treatment for advanced bladder cancer is cisplatin-based chemotherapy. Patients receiving this therapy have a median survival of 12-15 months. However, for 30-50% of patients with advanced bladder cancer, cisplatin chemotherapy is not considered a safe option due to their advanced age, kidney function, and/or ongoing medical conditions. Such patients may receive carboplatin-based chemotherapy, which provides a median survival of 9-10 months.
This study received funding from Genentech, a member of the Roche Group.
View the full abstract.
For more information:
- Guide to Bladder Cancer
- Understanding Immunotherapy
- Advanced Cancer
- Coping with Metastatic Cancer
- Cancer.Net Blog
1De Santis M, Bellmunt J, Mead G, et al. Randomized phase II/III trial assessing gemcitabine/carboplatin and methotrexate/carboplatin/vinblastine in patients with advanced urothelial cancer who are unfit for cisplatin-based chemotherapy: EORTC study 30986. J Clin Oncol. 2012 Jan 10;30(2):191-9.
2http://seer.cancer.gov/statfacts/html/urinb.html. Accessed on May 13, 2016.
3 http://www.wcrf.org/int/cancer-facts-figures/data-specific-cancers/bladder-cancer-statistics. Accessed on May 13, 2016.