Treatment with the anti–PD-1 therapy nivolumab after surgery helped reduce cancer recurrence in patients with urothelial cancer of the bladder or other sites in the urinary tract that had invaded the muscle and therefore posed a high risk for recurrence, according to clinical trial results presented by Matthew Galsky, MD, at the 2022 American Urological Association Annual Meeting. These findings were also published in The Journal of Urology.
The results support giving adjuvant nivolumab as the standard of care for patients who have muscle-invasive urothelial carcinoma. About 700 patients participated in the phase III, randomized, double-blind CheckMate 274 trial; half were given nivolumab and the other half placebo after having surgery with chemotherapy beforehand.
Matthew Galsky, MD
“Longer-term follow-up data are important for reinforcing the initial results we published last year demonstrating for the first time that immunotherapy administered after surgery for bladder cancer and other urothelial cancer can decrease the risk of cancer recurrence,” said Dr. Galsky, Director of Genitourinary Medical Oncology at Mount Sinai Tisch Cancer Center. “Almost 200,000 people die each year of urothelial cancer worldwide, so advances like immunotherapy being used in this manner bring hope.”
Surgery that removes the bladder or kidney and ureter has been the standard of care for patients with urothelial cancer that has entered surrounding muscle or lymph nodes, but approximately half of these patients later relapse. Unfortunately for these patients, no consensus has emerged regarding treatments after surgery that might reduce the risk of cancer recurrence.
In CheckMate 274, with a minimum of 11 months’ follow-up, patients who received nivolumab had an approximately 30% lower likelihood of developing cancer recurrence than those who received placebo. Patients with PD-L1–positive tumors had cancer-free rates that were even higher.
These longer-term disease-free survival data presented at the American Urology Association Annual Meeting built upon initial data presented by Dr. Galsky and colleagues in The New England Journal of Medicine. Follow-up with patients in this trial is ongoing.
Disclosure: For full disclosures of the study authors, visit auajournals.org.
