Andrea Apolo, MD
Andrea Apolo, MD, presented promising early data at the 2017 Genitourinary (GU) Cancers Symposium demonstrating the activity and safety of cabozantinib and nivolumab (Opdivo), with or without ipilimumab (Yervoy), in bladder cancer and other advanced genitourinary cancers.1
I think it’s a new treatment paradigm in bladder cancer. Immunotherapy is effective and I think right now, we are looking into doing better than what we're doing now and improving upon the response rate by using combination therapy.
Here at the GU Symposium, we present a pooled analysis of 2 cohorts that we had in metastatic bladder cancer patients treated with avelumab, which is a PD-L1 inhibitor. We had a 44-patient cohort of metastatic bladder cancer patients, and then a 200-patient cohort, and we pooled the data together. Looking at the patients who had a follow-up of greater than 6 months—about 150 patients—we found an overall response rate of 17.6%, so that was very exciting. We also found in patients with poor prognostic features the avelumab was very well tolerated.
Currently, there is a phase III trial of avelumab being tested in patients with metastatic bladder cancer in the maintenance setting. So, these are patients after receiving first-line therapy with chemotherapy and if they have a response, they go on to received avelumab therapy versus observation to see if there is a change in overall outcome.
- Apolo A, Mortazavi A, Stein MN, et al. A phase I study of cabozantinib plus nivolumab (CaboNivo) and ipilimumab (CaboNivoIpi) in patients (pts) with refractory metastatic urothelial carcinoma (mUC) and other genitourinary (GU) tumors. J Clin Oncol 35, 2017 (suppl 6S; abstract 293).
- Patel MR, Ellerton JA, Infante JR, et al. Avelumab in patients with metastatic urothelial carcinoma: Pooled results from two cohorts of the phase 1b JAVELIN Solid Tumor trial. J Clin Oncol 35, 2017 (suppl 6S; abstract 330).
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