Bernard H. Bochner, MD, FACS, Sir Murray F. Brennan Chair in Surgery, Memorial Sloan Kettering Cancer Center, discusses promising targets and pathways in the treatment of patients with bladder cancer.
Bernard H. Bochner, MD, FACS, Sir Murray F. Brennan Chair in Surgery, Memorial Sloan Kettering Cancer Center, discusses promising targets and pathways in bladder cancer.
Immunotherapy has shown a lot of promise in bladder cancer, Bochner says. This is likely related to the high tumor mutational burden (TMB) associated with bladder cancers. In other immunogenic tumors such as lung cancer and melanoma, TMB is also considerably high. With immunotherapy, physicians are able to exploit the DNA damage repair pathway. Currently, there are 7 FDA-approved checkpoint inhibitors in bladder cancer, 5 of which are approved as second-line treatment for platinum-refractory patients, and 2 of which are approved as frontline treatment for platinum-ineligible patients.
Next-generation sequencing tests have also identified cell growth and signaling pathways that may be useful in the future. From a molecular standpoint, it is important to remember that bladder cancer is not 1 disease but a multitude of different subtypes. It is a ripe field for investigation, in which there is plenty of room for progress, Bochner concludes.