Dr. Petrylak on Ongoing Investigations of Checkpoint Inhibition in Bladder Cancer

Daniel P. Petrylak, MD, professor of Medicine and Urology, Yale Cancer Center, discusses immune checkpoint inhibitors that are currently being evaluated for the treatment of patients with bladder cancer.

Following the FDA approval of atezolizumab (Tecentriq), researchers in this space are continuing to investigate the efficacy of immune checkpoint inhibitors in the treatment of this disease. Several first- and second-line trials are currently evaluating these agents.

Durvalumab, for example, has about a 25% response rate, explains Petrylak. Pembrolizumab (Keytruda) has also recently been evaluated in a randomized trial compared with investigator's choice of chemotherapy. Petrylak says a recent press release showed an advantage for pembrolizumab in that study, though the full data are not yet available. He hopes that these data will lead to more FDA approvals in bladder cancer.

In terms of deciding which patients are most likely to benefit from treatment with a checkpoint inhibitor, Petrylak says he looks primarily at a patient’s age and performance status. Also, if a patient has had an autoimmune disease, that factor automatically eliminates them from going on this type of drug.