Immunotherapy is a ‘Powerful Tool’ for Treating Urothelial Cancer

Studies of this treatment Including Durvalumab (Imfinzi) are ongoing

• Immunotherapy can be considered in the frontline setting for patients who are not candidates for chemotherapy
• Patients who qualify for this treatment typically receive pembrolizumab or atezolizumab
• Durvalumab (brand name: Imfinzi) was in consideration, but its manufacturer pulled the indication when it failed to meet primary end points

Platinum-based chemotherapy remains the standard of care for the treatment of patients with metastatic urothelial cancer in the frontline setting. However, for patients who are not candidates for chemotherapy or who have PD-L1 positive tumors, immunotherapy may be considered for frontline use.

“Immunotherapy is a really powerful tool that we use in urothelial cancer in all different disease states,” Dr. Jeannie Hoffman-Censits, medical oncologist and bladder cancer specialist at Johns Hopkins, tells SurvivorNet Connect. “There are probably hundreds of clinical trials ongoing.” When patients qualify for immunotherapy, they typically receive pembrolizumab or atezolizumab.

For maintenance therapy, avelumab is already being used in clinical practice. Durvalumab (brand name: Imfinzi) was being considered for previously treated patients with locally advanced or metastatic bladder cancer, but AstraZeneca voluntarily pulled this indication when the trial did not meet its primary end points.

This isn’t the end for durvalumab, as other studies are investigating its use in different areas of urothelial cancer. “I think this is a drug that will continue to have a story moving forward in urothelial cancer,” Dr. Hoffman-Censits says. “What that story is, I’m not entirely sure.”