Bladder Cancer

PD-1 and PD-L1 inhibitors are generally well-tolerated, so most patients face little or no issues with the drugs. However, there are still some things to look out for.

Patients with non-muscle invasive bladder cancer experience high levels of distress, according to one study.

Immunotherapy is making landmark change in the treatment of patients with genitourinary (GU) cancers, with bladder cancer being the pioneer in the field, having five FDA-approved checkpoint inhibitors. But kidney cancer is not far behind, with a breakthrough therapy designation granted for a Keytruda (pembrolizumab) combination this past January.

The combination use of Cyramza (ramucirumab) plus docetaxel showed improvements in objective response rate (ORR) and a positive trend in overall survival (OS) among patients with advanced bladder cancer, according to additional results from the phase 3 RANGE trial.

In particular, patients whose tumors have certain genetic mutations may respond especially well to this combination approach.

While there are a few common and well-known checkpoints for bladder cancer, there are also many more than PD-1, PD-L1 and CTLA-4.

Chemotherapy can aid in making a tumor “hot” – meaning that it attracts tumor-infiltrating lymphocytes (TILs), which are linked to killing tumor cells – priming it to respond better to immunotherapy treatment.

After a recent FDA approval for an additional dosing schedule option for Opdivo, patients must be educated on the potential side effects that may occur between prolonged visits.

The Food and Drug Administration (FDA) has approved a supplemental biologics license application adding a four-week dosing schedule for Opdivo (nivolumab) across several of the PD-1 inhibitor’s indications.

Researchers from Israel, the United Kingdom (UK) and Canada sought to determine the cost-effectiveness of Keytruda for the second-line treatment of patients with advanced bladder cancer. Drug costs were compared between the US, UK, Canada and Australia.