Updates on systemic treatments for bladder cancer were discussed and examined in the second plenary session of the 7th European Multidisciplinary Meeting on Urological Cancers (EMUC15), with experts noting the small gains in drug therapy and possible prospects.
Prof. Cora Sternberg (IT) spoke on peri-operative chemotherapy and provided a compact overview of the challenges and prospects for bladder cancer patients. She noted that The Cancer Genome Atlas (TCGA) which is creating a genomic atlas of human cancer including significantly mutated and potential targeted agents with trials now in development.
Moreover, neoadjuvant and adjuvant trials with checkpoint inhibitors (and in combination) are also being initiated. Regarding neoadjuvant and adjuvant chemotherapy, Sternberg said there is “…a convergence of evidence in support of adjuvant chemotherapy and a strong likelihood that there will be level 1 data.”
She added: “Perioperative chemotherapy (neoadjuvant or adjuvant) for bladder cancer should be standard of care. Participation in clinical trials to investigate new therapies and biomarkers is imperative.”
Prof. Maria De Santis (GB), meanwhile, tackled targeted therapies and noted that by far there is no licensed new agents or targeted therapies for bladder cancer.She discussed the following targets such as FGFR3, HER- 1, 2 and VEGR, commenting on the current status of ongoing trials.
“Regarding targeting angiogenesis in metastatic bladder cancer, overall benefit seems minimal, particularly with monotherapy,” said De Santis in her concluding remarks, adding that there is encouraging preliminary data with bevacizumab and ramucirumab.
Speaker Thomas Powles (GB) discussed immune therapies and said immune checkpoint inhibitors are active in bladder cancer. “Randomised trials to define survival are expected soon and moreover combination and adjuvant studies are ongoing. The future is bright,” said Powles adding that he expects major gains within five years.