Formal discussant of both trials, Jonathan Rosenberg, MD, of the Genitourinary Division at Memorial Sloan Kettering Cancer Center in New York, agreed that both studies move the field of antiangiogenesis in advanced bladder cancer forward.

“The very high overall response rates in the pazopanib plus paclitaxel study have not been seen in the second-line setting. The progression-free survival is also quite good. This study shows that the combination of chemotherapy and antiangiogenesis inhibition may play a role in bladder cancer. Tolerability is an issue, since the majority of patients required dose reductions and 44% needed growth factor support,” Dr. Rosenberg said.

The second study had positive results, and the combination of ramucirumab plus docetaxel will be studied in phase III. “In this study, the median progression-free survival was very respectable,” Dr. Rosenberg continued.

“Both studies were done in previously treated metastatic bladder cancer. There is reason to be hopeful that antiangiogenesis plus chemotherapy will turn out to be a valid option in a disease with no approved therapies,” concluded Dr. Rosenberg. ■

Disclosure: Dr. Rosenberg has served as a consultant to Eli Lilly.