IBCN 2017: Bladder Cancer Pipeline- The I-O Development in Bladder Cancer

Lisbon, Portugal (UroToday.com) Peter Goebel from Friedrich-Alexander University, Erlangen, Germany and others discussed the role of PD1/PDL1 inhibitors and data from recent trials. Further role according to molecular subtypes are critical in order to determine role according to molecular subtype. Even regarding PDL1 expression, we find conflicting data which would be further elucidated according to subtype as well as genotype. Moreover, tumor mutational burden, epithelial mesenchymal transition and IFN gamma signature are important to determine response to these inhibitors.

Glucocorticoid induced TNFIR-related protein (GITR) is an activating receptor on the surface of the T cells and other immune cells. Early trial results promising with no additional toxicity when compared to PD1/PDL1 inhibitors. Results are from other non-genitourinary cancers and this holds promise as an adjuvant treatment among bladder cancer patients (metastatic and non-metastatic) to provide long-term efficacy with at least 15% improvement over standard chemotherapy.

Lymphocyte-activation gene 3 (LAG3) is an immune checkpoint receptor expressed on the surface of both activated T cells and other immune cells. LAG3 may be considered in combination and stratification schematics of future trials. Moreover, exploratory analyses using LAG3 among patients resistant to PD1/PDL1 inhibitors. LAG3 among other immunomodulatory agents are being explored further alone and in combination as we understand the immune/cancer interface.

Speaker(s): Peter Goebel, Friedrich-Alexander University, Erlangen, Germany

Written by: Stephen B. Williams, M.D., Associate Professor, Division of Urology, The University of Texas Medical Branch, Galveston, TX. and Ashish M. Kamat, M.D. Professor, Department of Urology, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX., at the International Bladder Cancer Network - October 21, 2017- Lisbon, Portugal

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