The immunotherapy agent Tecentriq® (atezolizumab) provides anti-cancer activity when used as initial therapy among patients with advanced bladder cancer who are not able to tolerate standard therapy. These results were recently presented at the 2016 annual meeting of the American Society of Clinical Oncology (ASCO).

Bladder cancer will be diagnosed in approximately 77,000 people in the United States this year alone. The average age that patients are diagnosed with bladder cancer is 70 years, with 80% of these patients being former smokers.

The most common type of bladder cancer is urothelial carcinoma, whereby cancer begins in the cells that line the bladder. Advanced bladder cancer refers to cancer that has spread outside the bladder to regional or distant sites in the body.

Because the majority of patients diagnosed with bladder cancer are elderly and/or former smokers, they are often too frail to be treated with the standard chemotherapy agent approved for the treatment of advanced stages of this disease, cisplatin. Patients who are not able to tolerate cisplatin may be treated with the chemotherapy agent carboplatin, which provides a median survival of approximately 9-10 months.

Tecentriq is an agent that helps to restore the body’s immune system in fighting cancer. It creates its anti-cancer effects by blocking a specific protein that is used by cancer cells to escape an attack by the immune system, called PD-L1. Once PD-L1 is blocked, cells of the immune system are able to identify cancer cells as a threat, and initiate an attack to destroy the cancer.

The United States Food and Drug Administration (FDA) has approved Tecentriq for the treatment of bladder cancer that has recurred or progressed following initial therapy.

Researchers have also recently evaluated Tecentriq as initial treatment of advanced bladder cancer among patients who are not able to tolerate standard initial therapy. The trial, referred to as the IMvigor210 trial, included patients with advanced bladder cancer who were not eligible for treatment with standard therapy. All patients were treated with Tecentriq.

The median follow-up of these patients is 14.4 months.

  • 24% of patients achieved anti-cancer responses.
  • 75% of patients who achieved responses had continued responses at the time of follow-up.
  • The median overall survival at the time of follow-up was 14.8 months.
  • Treatment with Tecentriq was generally well tolerated, with 6% of patients discontinuing therapy due to side effects. In contrast, approximately 20% of this patient population discontinues therapy when treated with carboplatin.

These results indicate that Tecentriq provides long-term anti-cancer responses as initial treatment among patients with advanced bladder cancer who are not eligible for standard therapy.

Trials further evaluating Tecentriq are ongoing to determine its effectiveness in different stages and patient populations with bladder cancer.

Reference: Balar A Galsky  Loriot Y et al. Atezolizumab (atezo) as first-line (1L) therapy in cisplatin-ineligible locally advanced/metastatic urothelial carcinoma (mUC): Primary analysis of IMvigor210 cohort 1. Proceedings from the 2016 annual ASCO meeting.  LBA4500.

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