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Sumanta K. Pal, MD, on Urothelial Cancer: Results From the CheckMate 275 Trial
Sumanta K. Pal, MD, of the City of Hope, discusses phase II findings on the efficacy and safety of nivolumab monotherapy in patients with metastatic urothelial cancer who have received prior treatment. Follow him on Twitter: @montypal
Arjun V. Balar, MD, on Urothelial Cancer: Results From KEYNOTE-052
Arjun V. Balar, MD, of the NYU Perlmutter Cancer Center, discusses preliminary phase II study findings on pembrolizumab as first-line therapy for advanced/unresectable or metastatic urothelial cancer. (Abstract LBA32)
Development and Validation of a Quality Assurance Score for Robot-Assisted Radical Cystectomy
What are the factors that add up to the best outcomes for patients who have surgery to treat cancer? Looking for a better way to measure quality of care and share best practices in surgical oncology, a team from Roswell Park Cancer Institute developed a quality assessment tool and validated it in a ...
High-Intensity Local Treatment May Improve Survival in Patients With Metastatic Urothelial Carcinoma of the Bladder
In a National Cancer Data Base analysis reported in the Journal of Clinical Oncology, Seisen et al found that high-intensity local treatment was associated with an overall survival benefit in patients with metastatic urothelial carcinoma of the bladder. Study Details The study included data from...
Nivolumab Receives FDA Breakthrough Therapy Designation for Advanced/Metastatic Urothelial Carcinoma
Bristol-Myers Squibb Company announced June 27 that the U.S. Food and Drug Administration (FDA) has granted Breakthrough Therapy Designation to nivolumab (Opdivo) for the potential indication of unresectable locally advanced or metastatic urothelial carcinoma that has progressed on or after a...
Is Anti–PD-L1 Antibody Durvalumab Active in Advanced Urothelial Bladder Cancer?
In a phase I/II study reported in the Journal of Clinical Oncology, Massard et al found that the anti–PD-L1 (programmed cell death ligand 1) antibody durvalumab was active in patients with previously treated advanced urothelial bladder cancer. Objective response appeared to be confined to...
Sumanta K. Pal, MD, and Toni K. Choueiri, MD, on Urothelial Carcinoma: Efficacy of an FGFR Inhibitor
Sumanta K. Pal, MD, of City of Hope, and Toni K. Choueiri, MD, of Dana-Farber Cancer Institute, discuss findings on BGJ398 in patients with previously treated advanced/metastatic urothelial carcinoma with FGFR3 alterations (Abstract 4517).
Jonathan E. Rosenberg, MD, and Toni K. Choueiri, MD, on Bladder Cancer: Mutation Burden and Atezolizumab
Jonathan E. Rosenberg, MD, of Memorial Sloan Kettering Cancer Center, and Toni K. Choueiri, MD, of the Dana-Farber Cancer Institute, discuss mutation burden—its role in response to treatment with PD-L1 immunotherapy and its impact on progression-free survival and overall survival, as well as the...
Arjun Vasant Balar, MD, on Urothelial Carcinoma: Analysis of the IMvigor210 Cohort 1
Arjun Vasant Balar, MD, of the Perlmutter Cancer Center at NYU Langone Medical Center, discusses findings on atezolizumab as first-line therapy in cisplatin-ineligible locally advanced/metastatic disease (Abstract LBA4500).
ASCO 2016: Atezolizumab Benefits Patients With Advanced Bladder Cancer
The anti–programmed cell death ligand 1 (PD-L1) immunotherapy atezolizumab (Tecentriq) is effective in patients with previously untreated advanced bladder cancer who are not eligible for the standard treatment with cisplatin. According to a nonrandomized phase II trial, atezolizumab shrank...
FDA Approves Atezolizumab for Advanced Urothelial Carcinoma
The U.S. Food and Drug Administration (FDA) today granted accelerated approval to atezolizumab (Tecentriq) for the treatment of urothelial carcinoma, the most common type of bladder cancer. This is the first programmed cell death protein 1/programmed death ligand 1 (PD-1/PD-L1) inhibitor to be...
A Critical Analysis of Early Bladder Cancer Recurrence After Laparoscopic Radical Cystectomy
Although laparoscopic radical cystectomy and robotic-assisted radical cystectomy continue to grow in popularity and are successful in the treatment of bladder cancer, they are still considered experimental approaches. Using data collected by the Section of Uro-Technology of the European Association ...
Phase II Trial Shows Benefit of Adding Ramucirumab to Docetaxel in Previously Treated Advanced Urothelial Carcinoma
Adding the anti–vascular endothelial growth factor receptor 2 (VEGFR-2) antibody ramucirumab to docetaxel improved progression-free survival among previously treated patients with locally advanced or metastatic urothelial carcinoma, reported Petrylak et al in the Journal of Clinical Oncology. ...
Study Finds Adaptive Image-Guided Radiation Therapy for Bladder Preservation Clinically Feasible in Urinary Bladder Cancer
A prospective study examining a trimodality treatment approach in localized bladder cancer cases using adaptive image-guided, intensity-modulated radiation therapy found that the bladder preservation rate at 3 years was 83%. These findings were published by Murthy et al in the International Journal ...
ASCO Endorses European Association of Urology Guideline on Muscle-Invasive and Metastatic Bladder Cancer
As reported in the Journal of Clinical Oncology by Matthew I. Milowsky, MD, of the University of North Carolina Lineberger Comprehensive Cancer Center, and colleagues, ASCO has endorsed the European Association of Urology clinical practice guideline on muscle-invasive and metastatic bladder cancer. ...
MRI-Guided Adaptive Reoptimization in Radiotherapy Shows Promise in Urinary Bladder Cancer Treatment
A new radiotherapy technique could help doctors to focus treatment more precisely on tumors in the bladder and reduce damage to surrounding healthy tissue. Researchers showed that pretreatment imaging using magnetic resonance imaging (MRI) was effective at guiding radiotherapy toward tumors in the...
Atezolizumab Active in Previously Treated Locally Advanced or Metastatic Urothelial Carcinoma
The anti–PD-L1 (programmed cell death ligand 1) antibody atezolizumab produced durable responses in a marked proportion of patients with previously treated locally advanced or metastatic urothelial carcinoma, according to a phase II trial reported in The Lancet by Rosenberg et al. The...
Peter E. Clark, MD, on a Guideline Update in the Management of Bladder Cancer
Peter E. Clark, MD, of the Vanderbilt-Ingram Cancer Center discusses the highlights of the 2015 NCCN Guidelines for bladder cancer in both non–muscle invasive and muscle-invasive disease.
Derek Raghavan, MD, PhD: Roundup of Clinical Trial Results on Genitourinary Cancers
Derek Raghavan, MD, PhD, of the Levine Cancer Institute, gives his insights into key genitourinary cancer clinical trials presented at the 2015 ASCO Annual Meeting and his thoughts on where the research is headed.
Jonathan E. Rosenberg, MD, on Results of the IMvigor 210 Study on Atezolizumab in Locally Advanced or Metastatic Urothelial Cancer
Jonathan E. Rosenberg, MD, of Memorial Sloan Kettering Cancer Center, discusses this pivotal study of an investigational immunotherapy that has shown increased and durable responses, with a relatively benign toxicity profile (Abstract 21LBA).
Srikala S. Sridhar, MD: Bladder Cancer Update
Srikala S. Sridhar, MD, of the Princess Margaret Cancer Centre, summarizes important papers presented on bladder and urothelial cancers, including perspectives on immunotherapies and radiotherapies.
GU Symposium 2016: Updated Results of IMvigor 210 Show Durable Response Rates With Atezolizumab in Advanced Bladder Cancer
In the pivotal phase II IMvigor 210 study, the investigational cancer immunotherapy atezolizumab (MPDL3280A) showed encouraging response rates in patients with locally advanced or metastatic urothelial carcinoma, Roche announced. These data were presented by Hoffman-Censits et al at the 2016...
Study Finds Investigational Personalized Peptide Vaccination Increased Survival in Patients With Advanced Bladder Cancer
Although urothelial cancer of the bladder is sensitive to platinum-based chemotherapy, the vast majority of patients treated with these therapies will develop progressive disease within 8 months of treatment, and the median survival is reported to be between 13 and 15 months, according to a new...
ECC 2015: Atezolizumab in Locally Advanced or Metastatic Urothelial Carcinoma: Results of the IMvigor 210 Study
At the 2015 European Cancer Congress in Vienna, Austria, early results were announced (Abstract 21LBA) from a pivotal phase II study, IMvigor 210, of the investigational cancer immunotherapy atezolizumab (anti–PD-L1; MPDL3280A) in people with locally advanced or metastatic urothelial...
Study Identifies Genetic Mutations That Predict Response to Chemotherapy in Bladder Cancer
Although cisplatin-based neoadjuvant chemotherapy before cystectomy is the standard of care for muscle-invasive bladder cancer, only between 25% and 50% of patients achieve a pathologic response. A study investigating biomarkers that can predict response to chemotherapy in patients with...
Analysis Suggests Use of Pioglitazone for Diabetes May Increase Risk of Prostate and Pancreatic Cancers But Not Bladder Cancer
Available data suggest an increased risk of bladder cancer with pioglitazone treatment for diabetes. In an analysis of Kaiser Permanente Northern California data reported in JAMA, Lewis et al found no significantly increased risk of bladder cancer in patients with diabetes ever using pioglitazone....
Similar Long-Term Outcomes With Robotic vs Traditional Surgery in Patients With Bladder Cancer
In the largest multi-institutional study to date, patients diagnosed with bladder cancer and treated with robot-assisted surgery experienced similar results to those who underwent a traditional open operation, according to research led by scientists at Roswell Park Cancer Institute (RPCI). The ...
Immune Signaling Protein May Have Opposing Roles in Breast Cancer Development
Researchers at The University of Texas MD Anderson Cancer Center have discovered that inhibiting the immune receptor protein TLR4 may not be a wise treatment strategy in all cancers, as research now shows TLR4 can either promote or inhibit breast cancer cell growth depending on mutations in...
Adjuvant Chemotherapy Improves Survival in Patients With Locally Advanced Bladder Cancer
Patients who received chemotherapy after bladder cancer surgery demonstrated an approximately 30% lower risk of death than those who underwent surgery alone, according to an analysis presented by researchers at the Icahn School of Medicine at Mount Sinai at the 2015 Genitourinary Cancers Symposium, ...
Laparoscopic Surgery for Bladder Cancer Leads to Good Long-Term Cancer Control
Long-term survival rates following laparoscopic surgery for bladder cancer are comparable to those of open surgery, according to a study published in BJU International. The findings, which come from the largest study to date with long-term follow-up after this type of minimally invasive surgery,...
No Overall Survival Difference for Immediate vs Deferred Chemotherapy After Radical Cystectomy in Muscle-Invasive Bladder Cancer
In the phase III EORTC 30994 trial reported in The Lancet Oncology, Sternberg et al found no overall survival difference between immediate and delayed adjuvant chemotherapy after radical cystectomy in patients with muscle-invasive urothelial carcinoma of the bladder. Immediate treatment was...
Anti-PD-L1 Antibody Shows Activity in Metastatic Urothelial Bladder Cancer
As reported in a letter to Nature by Powles et al, the anti–PD ligand-1 (PD-L1) antibody MPDL3280A has shown good activity in patients with metastatic urothelial bladder cancer in a phase I study. Outcomes were best in patients with PD-L1 immunohistochemistry (IHC) expression of 2 or 3 in...
‘Wound Response’ of Cancer Stem Cells May Explain Chemoresistance in Bladder Cancer
A novel mechanism—similar to how normal tissue stem cells respond to wounding—might explain why bladder cancer stem cells actively contribute to chemoresistance after multiple cycles of chemotherapy drug treatment. Targeting this “wound response” of cancer stem cells can...
Novel Genomic Signature Predicts Postcystectomy Recurrence in High-Risk Bladder Cancer
As reported in the Journal of the National Cancer Institute, Mitra et al have identified a novel genomic-based signature that improves prediction of postcystectomy recurrence in patients with high-risk bladder cancer. Use of the signature could help guide selection of patients for adjuvant therapy...
RTOG Pooled Analysis Shows Good Long-Term Outcomes After Bladder-Preserving Combined-Modality Therapy for Muscle-Invasive Bladder Cancer
In a pooled analysis of prospective Radiation Therapy Oncology Group (RTOG) studies reported in the Journal of Clinical Oncology, Mak et al found good long-term outcomes with bladder-preserving combined-modality therapy for muscle-invasive bladder cancer. Study Details The analysis included 468...
14 Million Major Medical Conditions Attributable to Cigarette Smoking
At least 14 million major medical conditions among U.S. adults aged 35 years and older were attributed to cigarette smoking by a study estimating the disease burden of cigarette smoking, which, according to the study’s authors, “remains immense.” Among current and former smokers,...
Increased Risk of Fracture After Radical Cystectomy and Urinary Diversion in Older Patients With Bladder Cancer
In a population-based study reported in the Journal of Clinical Oncology, Gupta et al found that radical cystectomy with urinary diversion for bladder cancer is associated with increased risk of bone fracture at any site in Medicare patients. Radical cystectomy and urinary diversion may cause...
No Difference in Complication Rates or Hospital Stay With Robot-Assisted vs Open-Surgery Cystectomy in Bladder Cancer
In a trial reported in The New England Journal of Medicine, Bochner et al found no difference in complication rates or length of hospital stay with robot-assisted laparoscopic radical cystectomy vs open surgery in patients with bladder cancer. Blood loss was greater and procedure time shorter with...
ASCO 2014: Investigational Anti–PD-L1 Antibody Demonstrates Promising Activity in Certain Patients With Metastatic Bladder Cancer
In a phase I study, the investigational anti–programmed death-ligand 1 (PD-L1) monoclonal antibody MPDL3280A demonstrated promising overall response rates in patients with previously treated metastatic urothelial bladder cancer whose tumors were characterized as PD-L1–positive. The ...
Accelerated Methotrexate, Vinblastine, Doxorubicin, Cisplatin With Pegfilgrastim Is Effective, Well-Tolerated Neoadjuvant Therapy for Bladder Cancer
Although neoadjuvant cisplatin-based chemotherapy is standard of care for muscle-invasive bladder cancer, it is not widely used due to concerns over toxicity and delayed cystectomy. In a phase II trial reported in the Journal of Clinical Oncology, Plimack et al evaluated whether a neoadjuvant...
Neoadjuvant Dose-Dense Methotrexate, Vinblastine, Doxorubicin, Cisplatin With Pegfilgrastim: Safe and Effective in Muscle-Invasive Urothelial Cancer
In a phase II trial reported in the Journal of Clinical Oncology, Choueiri et al found that a neoadjuvant four-cycle/8-week regimen of dose-dense methotrexate, vinblastine, doxorubicin, and cisplatin was well tolerated and effective in patients with muscle-invasive urothelial cancer. Study Details ...
Perioperative Chemotherapy for High-Risk Bladder Cancer Improves Survival but Is Not Routinely Administered
A recent study published in Cancer found that, contrary to treatment guidelines for high-risk bladder cancer, neoadjuvant chemotherapy is not commonly used in routine clinical practice. Utilization of adjuvant chemotherapy was found to be increasing over time and was associated with a substantial...
Certain Genetic Variants May Help Identify Patients at Increased Risk of Bladder Cancer Recurrence
A new study by Andrew et al published in BJU International suggests that certain inherited DNA sequences may affect the prognosis of patients with bladder cancer. The findings may help physicians identify subgroups of patients with high-risk bladder cancer who should receive more frequent...
DNA Test Can Help Predict Bladder Cancer Recurrence
A DNA methylation marker test performed on patients with noninvasive urothelial carcinoma can predict tumor recurrence with high sensitivity and specificity, according to a study by Su et al. The findings may help eliminate costly and unnecessary invasive exams and reveals the importance of DNA...
Patient With Bladder Cancer Shows Exceptional Response to Everolimus/Pazopanib Combination
A phase I study by Wagle et al of a combination of everolimus and pazopanib in patients with advanced solid tumors has identified a patient with bladder cancer who had a 14-month complete response. The patient had two concurrent mutations in mTOR, the target of everolimus (Afinitor), which may have ...
Molecular Features of Invasive Bladder Cancer Resemble Those of Breast Cancer
Using whole-genome mRNA-expression profiling, researchers have identified three molecular subtypes of muscle-invasive bladder cancers that shared molecular features with basal and luminal breast cancers. The findings have important implications for prognostication, the future clinical development...
Patients With Near-Complete Response After Induction Therapy May Be Candidates for Bladder-Sparing Therapy
Bladder-sparing approaches are typically reserved for patients with bladder cancer who have a complete response to combined modality induction therapy (radiation plus chemotherapy). A new phase II study suggests that patients with near-complete response should also be considered for bladder-sparing ...
Bladder Cancer Study Uncovers Potential Drug Targets and Molecular Similarities to Other Cancers
Investigators with The Cancer Genome Atlas Research Network have identified new potential therapeutic targets for urothelial carcinoma of the bladder, a common cancer that causes about 150,000 deaths worldwide each year. The researchers also found molecular similarities to some subtypes of breast,...
STAG2 Mutation Found Linked to Low-Risk Bladder Cancer
An international research team led by scientists from Georgetown Lombardi Comprehensive Cancer Center has discovered a genetic mutation linked to low-risk bladder cancer. The findings, published in Nature Genetics, identified STAG2 as one of the most commonly mutated genes in bladder cancer,...
Standard and Reduced High-Dose Volume Radiation Therapy for Muscle-Invasive Bladder Cancer Have Comparable Tumor Control
Standard and reduced high-dose volume radiation therapy for muscle-invasive bladder cancer provide comparable tumor control and decreased late toxicity when compared to surgery, according to a study published in the October issue of the International Journal of Radiation Oncology...
