Dr. Schmid on the Rationale for the RACE IT Trial in Advanced Urothelial Carcinoma

Sebastian C. Schmid, MD, oncologist, Rechts der Isar Medical Center, Technical University of Munich, Germany, discusses the rationale for the phase 2 RACE IT trial (NCT03529890) in urothelial carcinoma.

Preoperative radiation therapy plus nivolumab (Opdivo) prior to radical cystectomy was evaluated in the phase 2 RACE IT trial in patients with locally advanced urothelial carcinoma.

This trial investigated a population of patients that have a poor prognosis. For example, patients from this population who are treated with surgery alone have survival rates as low as 20% to 30%, Schmid explains. Moreover, this patient population doesn’t benefit substantially from neoadjuvant chemotherapy, leaving room for improvement, Schmid adds.

Checkpoint inhibitors in combination with radiation therapy could lead to improved outcomes in this population, Schmid continues. Radiation therapy has an immunostimulating effect, boosting the activity of checkpoint inhibitors. There are also immune depressing effects associated with radiation that can be counteracted by immune checkpoint inhibitors, Schmid concludes.