Revolutionary Advances for Treating Urothelial Carcinoma - Episode 3

Durvalumab FDA Approval for Bladder Cancer

Transcript:Evan Yu, MD: Durvalumab is a PD-L1 antibody similar to atezolizumab. I think some of the differences that we’ve seen, if we’re parsing out differences from open-label phase II studies, are that the durvalumab studies have utilized a different antibody to do PD-L1 staining, and they found patients that have a very high percentage of PD-L1 staining and are able to concentrate good responses in those patients. So, that’s one thing to focus on.

I think another interesting thing with durvalumab is that they’re very focused on combination therapies. They have a frontline trial of durvalumab with tremelimumab versus durvalumab alone versus standard chemotherapy. And I think that combination immunotherapy approach could be a very interesting path for the future.

I believe that the future of treatment of metastatic urothelial carcinoma will bring more and more immuno-oncology agents. I think the first thing that we’ll notice is more use earlier in the first-line metastatic disease setting. That’s going to be very, very noticeable. And chemotherapy may be used less in that setting. We might see more later-stage chemotherapy used—or even situations where chemotherapy doesn’t get used. I think it’ll be very important to see the results of some of the front-line trials—a combination of immuno-oncology agents with chemotherapy, combinations of multiple immuno-oncology agents. These things could really change the landscape even more.

I think the other thing we should look forward to is the use of these immuno-oncology agents earlier in the disease state. There are some unmet needs, such as neoadjuvant therapy. We could improve upon what we’re doing right now with cisplatin-based chemotherapy. Adjuvant therapy is a completely unmet need. And non—muscle invasive bladder cancer, when you have BCG-refractory disease, is really an unmet need, and there a lot of patients who would like to preserve their bladder rather than move on to cystectomy. So, I really see the future changing dramatically with all these immuno-oncology agents, and I think there are many other agents to come down the road.

Transcript Edited for Clarity