Buenos Aires, Argentina (UroToday.com) Yves Fradet, Professor University of Laval, discussed key concepts in immunotherapy in urothelial carcinoma. BCG was an initial agent using the immune system to kill cancer cells using anti-tumor T cell response.
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Bladder cancer is among the cancers with the greatest number of mutations which brings attention to tumor antigens and how we can use the immune system to destroy cancer cells. PD-1/PD-L1 pathway is imperative. PDL-1 expression can be regulated by different mechanisms and blockade of PDL-1 or PD-1 can inhibit signaling. Immune checkpoint inhibitors include anti PDL-1, anti PD-1 and anti-CTLA4. IMvigor 201 results recently have shown minimal side effects with median time to first response at 2.1 mo with results suggesting durable oncologic efficacy with improved overall survival in patients with PDL-1 expression. The pathway is complex and perhaps sue in combination and/or sequential with chemotherapy may lead to improved response. Additional immunological checkpoints are being studies including TIM-3 blockade which are being increasingly explored. Sophisticated biomarkers to better assess the tumor-host interaction status with be essential to personalized treatments and their adoption will be driven by the high costs associated with treatments.
World Urological Oncology Federation Symposium at the SIU Congress 2016 - October 20 - 23, 2016 – Buenos Aires, Argentina
Written By: Stephen B. Williams, M.D., Assistant Professor in Urology, The University of Texas Medical Branch, Galveston, TX. and Ashish Kamat, M.D. Professor, Department of Urology, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX.