IBCN 2019: Platinum-Based Neoadjuvant Chemotherapy on the Bladder Tumor Microenvironment

Aarhus, Denmark (UroToday.com) Dr. Jeroen van Dorp from the Netherlands Cancer Institute presented his work investigating the effect of platinum-based neoadjuvant chemotherapy (NAC) on the bladder tumor microenvironment. Patients who had a near-complete response were identified with paired formalin-fixed paraffin-embedded tissue available from 45 cases. Pairs were said to comprise of TURBT tissue and post-chemotherapy cystectomy specimens.

The PanCancer IO 360 gene expression nanostring panel was used to characterize the RNA isolated from these specimens. Dr. van Dorp noted that there was significant upregulation of multiple genes related to disease progression and chemotherapy resistance, with an increase in the antigen-presenting score. PD-1, PD-L1, CTLA-4, and TIM-3 were all found to be increased in treated tissue as well. These data suggest that immunotherapy may benefit patients who fail to demonstrate a true complete response following neoadjuvant chemotherapy.

Abstract take-home messages:

  • An analysis of the tumor microenvironment of patients who received NAC for MIBC but who did not achieve complete response found that PD-1, PD-L1, CTLA-4, and TIM-3 were all increased in treated tissue, suggesting that immunotherapy may benefit patients who fail to demonstrate a full CR following neoadjuvant chemotherapy.
Presented by: Jeroen van Dorp, MD, PhD student, the Netherlands Cancer Institute 

Written by Dr. Vikram M. Narayan (@VikramNarayan), Urologic Oncology Fellow with Ashish M. Kamat, MD (@UroDocAsh), Professor, Department of Urology, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX at the 17th meeting of the International Bladder Cancer Network, (IBCN, #IBCN2019) October 3rd – 5th, 2019 in Aarhus, Denmark.