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Chemotherapy May Be Vital to Long-Term Immunotherapy Efficacy in Bladder Cancer

Caroline Seymour
Published: Wednesday, Mar 14, 2018

Parminder Singh, MD

Parminder Singh, MD
In bladder cancer, combination strategies, particularly the combination of immunotherapy and chemotherapy, are under investigation. Chemotherapy, says Parminder Singh, MD, is going to make a comeback to improve treatment efficacy.

State of the Science Summit™ on Genitourinary Cancers, Singh, hematologist/ oncologist, Mayo Clinic, discussed the potential of immunotherapy, the importance of sequencing to avoid disease progression, and the use of chemotherapy and radiation therapy to reach an unmet need in muscle-invasive disease.

OncLive®: What is the state of immunotherapy in bladder cancer?

Singh: Immune therapy is efficacious for patients with bladder cancer, but there are potential toxicities and interactions with other medications to be aware of. 

KEYNOTE-045 showed that pembrolizumab (Keytruda) sustained its improvement in overall survival compared with chemotherapy. Is the future headed toward combination approaches or continued use of single-agent therapy?  

We already have 5 FDA-approved agents based on immune checkpoint pathways. They all have activity as single agents, but we know the activity of these agents is limited to a small group of patients. We want to expand those results to other patients who progress.
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