New Challenges Exposed in Treating Bladder Cancer

Just Because an Answer is Presented with Obstacles That Doesn't Mean it's Impossible.
Just Because an Answer is Presented with Obstacles That Doesn’t Mean it’s Impossible.

Checkpoint inhibitors, one of the major forms of cancer immunotherapy, have played a significant role in the way doctors treat bladder cancer. Researchers are now tackling new challenges in order to improve the effectiveness of these treatments.

Checkpoint Inhibitors and Bladder Cancer

Five checkpoint inhibitors recently received approval from the Food and Drug Administration: Keytruda, Opdivo, Tecentriq, Imfinzi and Bavencio. All five have been tested as both first-line and second-line treatments.

When used with patients who had previously been untreated, these therapies achieved a positive response in 15 to 25 percent. As second-line treatments for patients who had received chemotherapy, only Keytruda showed improvement in overall survival rates.

Solving the Puzzle of Patient Selection

Andrea Necchi, a medical oncologist from Italy, spoke on the topic at last year’s European Multidisciplinary Meeting on Urological Cancers. Necchi explained that patients who respond to checkpoint inhibitors have a high chance of success, so it becomes an issue of patient selection.

According to Necchi, one condition that appears to inhibit use of cancer immunotherapy is the presence of mutations in fibroblast growth factor receptors (FGFR). Testing of pan-FGFR receptors suggests that using them before or after treatment with checkpoint inhibitors could increase chances of a positive response.

Since the use of the five checkpoint inhibitors alone will not boost survival rates, researchers are testing them in different combinations with other treatments, including other checkpoint inhibitors.

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