“It is clear that PD-1 and PD-L1 targeted immunotherapy now has a role in most patients with advanced urothelial cancer,” Robert J. Jones, MBChB, PhD, professor of clinical cancer research, University of Glasgow, Beatson West of Scotland Cancer Centre, commented in an invited discussion. “It is also true that cytotoxic chemotherapy maintains a role for many, and that both modalities are often ineffective and may be toxic.”
KEYNOTE-045 trial update
Initial results of KEYNOTE-045, at a median follow-up of 14.1 months, provided level I evidence for the safety and efficacy of pembrolizumab over chemotherapy as second-line therapy for recurrent, advanced urothelial cancer (N Engl J Med. 2017;376:1015-26), leading to approval for that indication. (Pembrolizumab is also approved as first-line therapy for cisplatin-ineligible patients).
Lead investigator Joaquim Bellmunt, MD, PhD, an associate professor of medicine at Harvard Medical School and director of the Bladder Cancer Center, Dana-Farber Cancer Institute, both in Boston, reported a trial update, now at a median follow-up of 27.7 months.
Susan London/Frontline Medical News
Dr. Joaquim Bellmunt
Results among 542 patients showed that the initial overall survival benefit of pembrolizumab over chemotherapy (vinflunine, paclitaxel, or docetaxel) (hazard ratio, 0.73; P = .0022) was sustained and in fact now somewhat greater with longer follow-up (HR, 0.70; P = .00017).