State-of-the-industry video lectures by leading urology experts
Latest Videos
Featured Videos

SAN FRANCISCO, CA USA ( - Nivolumab is a monoclonal antibody targeting PDL1, inducing immune-mediated anti-tumorigenesis.

Nivolumab has demonstrated dramatic and durable responses in the treatment of a wide variety of malignancies including renal cell carcinoma (RCC). Dr. David F. McDermott discussed ways in which to identify patients most likely to respond to PDL1 inhibition and also ways in which to improve response to PDL1 inhibitory therapy, particularly via combination with other immunotherapies or targeted therapies.

gucancerssympalt thumbDr. McDermott discussed studies aimed at identifying likely responders to PDL1 inhibition. Staining for PDL1 expression alone has not been shown to reliably predict response to nivolumab, as patients whose tumors are PDL1-negative may also exhibit a response to the drug. This lack of correlation between expression and response may be due to multiple factors, including tumor heterogeneity or increased PDL1 expression in the tumor microenvironment. Tumor heterogeneity contributes to the difficulty with good biomarker identification. As an example, he referenced a study presented at this conference which demonstrated differential PDL1 expression between primary and metastatic RCC sites.

He proceeded to address the question of whether patients with non-clear cell histology should be included in trials for nivolumab. Expression of PDL1 has been found in a small subset of patients with non-clear cell histology, and, thus, Dr. McDermott concluded that these patients should be considered for inclusion in nivolumab trials.

He followed with a discussion of the role of combination therapy in generating response to nivolumab in patients who otherwise would not respond. In a study examining the combination of nivolumab with ipilimumab (a CTLA4 inhibitor) in melanoma, significant declines in tumor size, with a durable response, were seen in a larger proportion of patients with PDL1-negative tumors than would be expected with nivolumab therapy alone. Multiple phase I trials are underway examining combination therapy with nivolumab at this time, and Dr. McDermott stated that he envisioned many of these immunotherapies and combination regimens over the next couple of years will become approved for use in several different types of solid tumors.

Despite this, he warned that the use of these immunotherapies in unselected patients would result in a high number of patients requiring salvage therapies, given the majority of tumors are not inflamed, and thus not likely to respond well to immunotherapy. Research into inducing antitumor activity is underway through such avenues as radiation therapy to tumor sites or the use of vaccines. He concluded by again emphasizing the importance of identifying patients who are most likely to benefit from this immunotherapy.

Highlights of a presentation by David F. McDermott, MD at the 2014 Genitourinary Cancers Symposium - January 30 - February 1, 2014 - San Francisco Marriott Marquis - San Francisco, California USA

The Dana-Farber Cancer Institute, Boston, MA USA

Written by Timothy Ito, MD, medical writer for

View Full 2014 GU Cancers Symposium Coverage



Publications focusing on urological cancer treatments through original commentary & articles
Everyday Urology Volume 3 Issue 2

Everyday Urology™ - Oncology Insights

From the Editor

PCAN cover

Prostate Cancer and Prostatic Diseases

From the Editor


Newsletter subscription

Free Daily and Weekly newsletters offered by content of interest

The fields of GU Oncology and Urology are rapidly advancing. Sign up today for articles, videos, conference highlights and abstracts from peer-review publications by disease and condition delivered to your inbox and read on the go.


Upcoming educational events
October 19-23, 2018 / European Society for Medical Oncology 2018 Congress
European Society for Medical Oncology 2018 Congress
October 19-20, 2018 / Hilton New York JFK Airport Hotel
16th International Conference on Nephrology & Therapeutics
October 19-20, 2018 / Hilton New York JFK Airport Hotel
3rd Annual Kidney Congress