Neoadjuvant PD-L1 plus CTLA-4 blockade in patients with cisp
Now open: Certificate Course in Management of Covid-19 by Govt. Of Gujarat and PlexusMDKnow more...Now open: Certificate Course in Management of Covid-19 by Govt. Of Gujarat and PlexusMDKnow more...
Immune checkpoint therapy is being tested in the neoadjuvant setting for patients with localized urothelial carcinoma with one study reporting data in cisplatin-ineligible patients who received anti PD-L1 monotherapy.

The study reported that patients with bulky tumors, a known high-risk feature defined as greater than clinical T2 disease, had fewer responses, with pathological complete response rate of 17%. They report on the first pilot combination neoadjuvant trial (NCT02812420) with anti-PD-L1 (durvalumab) plus anti-CTLA-4 (tremelimumab) in cisplatin-ineligible patients, with all tumors identified as having high-risk features (n?=?28).

High-risk features were defined by bulky tumors, variant histology, lymphovascular invasion, hydronephrosis and/or high-grade upper tract disease. The primary endpoint was safety and we observed 6 of 28 patients (21%) with grade ?3 immune-related adverse events, consisting of asymptomatic laboratory abnormalities (n?=?4), hepatitis and colitis (n?=?2).

Researchers also observed pathological complete response of 37.5% and downstaging to pT1 or less in 58% of patients who completed surgery (n?=?24). In summary, initial safety, efficacy and biomarker data with neoadjuvant combination anti-PD-L1 plus anti-CTLA-4, which warrants further development for patients with localized urothelial carcinoma, especially cisplatin-ineligible patients with high-risk features who do not currently have an established standard-of-care neoadjuvant treatment is provided.

Source: https://www.nature.com/articles/s41591-020-1086-y
Like
Comment
Share