San Antonio, Texas USA (UroToday.com) William Kim, University of North Carolina, discussed biomarkers in the immune checkpoint blockade. The biomarkers currently explored are PDL-1 and mutational load. PDL-1 + is a biomarker of response, however, there are patients who are negative which also have response to PDL-1 inhibitors.
Neoantigen burden correlates with response to immune checkpoint inhibition in other cancers and mutational burden correlates with response to inhibition in recent trials. Effector T cell signature correlates with response to immune checkpoint inhibitors and specially a 25 gene signature on IFN-gamma have biological and clinical implications. Immune gene signatures expression are highly correlated with response. Molecular subtypes have differential immune gene signatures expression mainly among basal and luminal subtypes although others have been further explored. There are conflicting reports among subtypes and response to immune checkpoint blockade which are illustrated by the IMvigor 210 and CheckMate 275 trials. The discrepancy among these trials may be due to differences in methods of molecular subtyping, accuracy of subtyping and lastly the end targets of blockade differ (anti PD-1 Vs anti PDL-1). The field of immunology in bladder cancer is rapidly evolving with trials emerging and further standardization of data reporting and in which patients based on molecular subtyping are needed to cohesively compare and understand how these inhibitors may benefit our patients.
Presented By: William Kim, University of North Carolina
Written By: Stephen B. Williams, MD and Ashish M. Kamat
17th Annual Meeting of the Society of Urologic Oncology - November 30 -December 2, 2016 – San Antonio, Texas USA