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Dr. Bellmunt Discusses Follow-Up Data for Pembrolizumab vs Chemotherapy in Bladder Cancer

Joaquim Bellmunt, MD, PhD, associate professor of medicine, Harvard Medical School, director, Bladder Cancer Center, Dana-Farber Cancer Institute, discusses 2-year follow-up results from the phase III KEYNOTE-045 trial of pembrolizumab (Keytruda) versus chemotherapy in recurrent, advanced urothelial carcinoma during the 2018 Genitourinary Cancers Symposium.

Joaquim Bellmunt, MD, PhD, associate professor of medicine, Harvard Medical School, director, Bladder Cancer Center, Dana-Farber Cancer Institute, discusses 2-year follow-up results from the phase III KEYNOTE-045 trial of pembrolizumab (Keytruda) versus chemotherapy in recurrent, advanced urothelial carcinoma during the 2018 Genitourinary Cancers Symposium.

The most important observation of these follow-up data is that 27% of patients that received pembrolizumab are still alive, compared with 14% of patients in the group assigned to receive chemotherapy.

At the 2-year follow-up, the hazard ratio has improved over the initial results, increasing from 0.73 to 0.70, showing that there is a 30% reduction in the risk of death in patients receiving pembrolizumab, Bellmunt says.

The initial results of the trial showed pembrolizumab had a superior response rate over chemotherapy, at 21% versus 11%. Investigators have now seen additional responses with subsequent follow-up, and the responses are durable. In the pembrolizumab arm, the median duration of response has not yet been reached, but is close to 50%. In the chemotherapy arm, the median duration of response is 4.5 months.

Bellmunt adds that investigators observed that additional duration of response may be even better in patients who are PD-L1 positive.

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