Dr. Singh on Potential Implications of the IMvigor130 Trial in Bladder Cancer

Parminder Singh, MD
Published: Wednesday, Dec 04, 2019



Parminder Singh, MD, hematologist/oncologist, Mayo Clinic, discusses potential implications of the phase III IMvigor130 trial in advanced bladder cancer.

According to data from the IMvigor130 trial, the frontline combination of atezolizumab (Tecentriq) and chemotherapy demonstrated a 1.9-month improvement in median progression-free survival versus placebo/chemotherapy in patients with locally advanced or metastatic urothelial carcinoma. Moreover, at the interim analysis, the median overall survival (OS) was 16.0 months and 13.4 months with atezolizumab/chemotherapy and placebo/chemotherapy, respectively (HR, 0.83; 95% CI, 0.69-1.00; P = .027).

Although these data were clinically meaningful, the OS data did not cross the prespecified interim efficacy boundary for significance. If the OS meets the prespecified endpoint with longer follow-up, the combination will likely be approved, says Singh. However, there are a lot of data that have yet to be presented which will impact how patients are treated in the frontline setting.

Singh is hopeful that with more mature data, immunotherapy will find its place in the first-line setting—in combination with either a traditional chemotherapy like gemcitabine and cisplatin or gemcitabine and carboplatin, or with a newer drug like enfortumab vedotin.
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Parminder Singh, MD, hematologist/oncologist, Mayo Clinic, discusses potential implications of the phase III IMvigor130 trial in advanced bladder cancer.

According to data from the IMvigor130 trial, the frontline combination of atezolizumab (Tecentriq) and chemotherapy demonstrated a 1.9-month improvement in median progression-free survival versus placebo/chemotherapy in patients with locally advanced or metastatic urothelial carcinoma. Moreover, at the interim analysis, the median overall survival (OS) was 16.0 months and 13.4 months with atezolizumab/chemotherapy and placebo/chemotherapy, respectively (HR, 0.83; 95% CI, 0.69-1.00; P = .027).

Although these data were clinically meaningful, the OS data did not cross the prespecified interim efficacy boundary for significance. If the OS meets the prespecified endpoint with longer follow-up, the combination will likely be approved, says Singh. However, there are a lot of data that have yet to be presented which will impact how patients are treated in the frontline setting.

Singh is hopeful that with more mature data, immunotherapy will find its place in the first-line setting—in combination with either a traditional chemotherapy like gemcitabine and cisplatin or gemcitabine and carboplatin, or with a newer drug like enfortumab vedotin.



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