Guru P. Sonpavde, MD, director, Bladder Cancer, and physician, Dana-Farber Cancer Institute, discusses therapeutic agents under investigation for patients with PD-L1–low bladder cancer.
Guru P. Sonpavde, MD, director, Bladder Cancer, and physician, Dana-Farber Cancer Institute, discusses therapeutic agents under investigation for patients with PD-L1—low bladder cancer.
There are trials being planned in that patient population, says Sonpavde, and time will tell whether or not the combination of chemotherapy and PD-1/PD-L1 inhibitors will be valuable in this setting. This approach also being looked at in ongoing phase III trials enrolling both cisplatin-eligible and -ineligible patients.
In addition, there is an Intergroup trial for cisplatin-ineligible patients that is comparing the combination of cisplatin and gemcitabine with or without bevacizumab (Avastin) or placebo. Those results are pending, adds Sonpavde. Finally, investigators are also looking into a “kitchen sink” approach in which several agents are being combined together, including durvalumab (Imfinzi) and tremelimumab—a PD-L1 inhibitor and a CLTA-4 inhibitor—plus platinum-based chemotherapy, compared with chemotherapy, or chemotherapy plus PD-L1 inhibition alone.