Abstract
Introduction
The survival of patients with metastatic urothelial cancer (mUC) is poor. During the last 40 years, chemotherapy was the predominant treatment modality for mUC. The discovery of the immune checkpoint inhibitors (ICI), especially the inhibitors of the programmed cell death 1 and its ligand (PD-1/PD-L1), has revolutionized cancer immunotherapy. The PD-1 and PD-L1 inhibitors provide a new and effective treatment option for patients with UC, particularly for patients with recurrence after platinum-based therapy and those who are ineligible for cisplatin.
Methods
A literature search on PubMed, ClinicalTrials.gov and selected annual congress abstracts was conducted in May 2018, using a combination of keywords, medical subject headings (MeSH) terms and free text incorporating urothelial bladder cancer; immunotherapy; immune checkpoint inhibition, biomarkers, PD1/PD-L1.
Results
Although some patients demonstrate complete and/or durable responses under ICI, the reliable prediction of response to ICI is not possible. In the clinical setting, physicians are not able to predict response to ICI in mUC and to adequately select patients who will benefit. Exploratory analysis of clinical trial data revealed that PD-L1 expression, tumor mutation burden, tumor-infiltrating lymphocytes and gene expression profiles might have some predictive and/or prognostic value in different patient populations.
Conclusion
Validated robust biomarkers are still needed to overcome this hurdle to forecast response of ICI in UC patients.
Similar content being viewed by others
References
Chang SS, Boorjian SA, Chou R, Clark PE, Daneshmand S, Konety BR, Pruthi R, Quale DZ, Ritch CR, Seigne JD, Skinner EC, Smith ND, McKiernan JM (2016) Diagnosis and treatment of non-muscle invasive bladder cancer: AUA/SUO guideline. J Urol 196(4):1021–1029. https://doi.org/10.1016/j.juro.2016.06.049
Alfred Witjes J, Lebret T, Compérat EM, Cowan NC, De Santis M, Bruins HM, Hernández V, Espinós EL, Dunn J, Rouanne M, Neuzillet Y, Veskimäe E, van der Heijden AG, Gakis G, Ribal MJ (2017) Updated 2016 EAU guidelines on muscle-invasive and metastatic bladder cancer. Eur Urol 71(3):462–475. https://doi.org/10.1016/j.eururo.2016.06.020
Ploussard G, Shariat SF, Dragomir A, Kluth LA, Xylinas E, Masson-Lecomte A, Rieken M, Rink M, Matsumoto K, Kikuchi E, Klatte T, Boorjian SA, Lotan Y, Roghmann F, Fairey AS, Fradet Y, Black PC, Rendon R, Izawa J, Kassouf W (2014) Conditional survival after radical cystectomy for bladder cancer: evidence for a patient changing risk profile over time. Eur Urol 66(2):361–370. https://doi.org/10.1016/j.eururo.2013.09.050
Stein JP, Lieskovsky G, Cote R, Groshen S, Feng A-C, Boyd S, Skinner E, Bochner B, Thangathurai D, Mikhail M, Raghavan D, Skinner DG (2001) Radical cystectomy in the treatment of invasive bladder cancer: long-term results in 1,054 patients. J Clin Oncol 19(3):666–675. https://doi.org/10.1200/jco.2001.19.3.666
NCCN guidelines for treatment of bladder cancer. https://www.nccn.org/professionals/physician_gls/default.aspx#site. Accessed 6 Oct 2018
Kaufman D, Raghavan D, Carducci M, Levine EG, Murphy B, Aisner J, Kuzel T, Nicol S, Oh W, Stadler W (2000) Phase II trial of gemcitabine plus cisplatin in patients with metastatic urothelial cancer. J Clin Oncol 18(9):1921–1927. https://doi.org/10.1200/jco.2000.18.9.1921
Hvd Maase, Hansen SW, Roberts JT, Dogliotti L, Oliver T, Moore MJ, Bodrogi I, Albers P, Knuth A, Lippert CM, Kerbrat P, Rovira PS, Wersall P, Cleall SP, Roychowdhury DF, Tomlin I, Visseren-Grul CM, Conte PF (2000) Gemcitabine and cisplatin versus methotrexate, vinblastine, doxorubicin, and cisplatin in advanced or metastatic bladder cancer: results of a large, randomized, multinational, multicenter, phase III study. J Clin Oncol 18(17):3068–3077. https://doi.org/10.1200/jco.2000.18.17.3068
Bellmunt J, Mottet N, De Santis M (2016) Urothelial carcinoma management in elderly or unfit patients. EJC Suppl 14(1):1–20. https://doi.org/10.1016/j.ejcsup.2016.01.001
Rosenberg JE, Hoffman-Censits J, Powles T, van der Heijden MS, Balar AV, Necchi A, Dawson N, O’Donnell PH, Balmanoukian A, Loriot Y, Srinivas S, Retz MM, Grivas P, Joseph RW, Galsky MD, Fleming MT, Petrylak DP, Perez-Gracia JL, Burris HA, Castellano D, Canil C, Bellmunt J, Bajorin D, Nickles D, Bourgon R, Frampton GM, Cui N, Mariathasan S, Abidoye O, Fine GD, Dreicer R (2016) Atezolizumab in patients with locally advanced and metastatic urothelial carcinoma who have progressed following treatment with platinum-based chemotherapy: a single-arm, multicentre, phase 2 trial. Lancet 387(10031):1909–1920. https://doi.org/10.1016/S0140-6736(16)00561-4
Sharma P, Retz M, Siefker-Radtke A, Baron A, Necchi A, Bedke J, Plimack ER, Vaena D, Grimm M-O, Bracarda S, Arranz JÁ, Pal S, Ohyama C, Saci A, Qu X, Lambert A, Krishnan S, Azrilevich A, Galsky MD (2017) Nivolumab in metastatic urothelial carcinoma after platinum therapy (CheckMate 275): a multicentre, single-arm, phase 2 trial. Lancet Oncol 18(3):312–322. https://doi.org/10.1016/S1470-2045(17)30065-7
Massard C, Gordon MS, Sharma S, Rafii S, Wainberg ZA, Luke J, Curiel TJ, Colon-Otero G, Hamid O, Sanborn RE, O’Donnell PH, Drakaki A, Tan W, Kurland JF, Rebelatto MC, Jin X, Blake-Haskins JA, Gupta A, Segal NH (2016) Safety and efficacy of durvalumab (MEDI4736), an anti-programmed cell death ligand-1 immune checkpoint inhibitor, in patients with advanced urothelial bladder cancer. J Clin Oncol 34(26):3119–3125. https://doi.org/10.1200/jco.2016.67.9761
Apolo AB, Infante JR, Balmanoukian A, Patel MR, Wang D, Kelly K, Mega AE, Britten CD, Ravaud A, Mita AC, Safran H, Stinchcombe TE, Srdanov M, Gelb AB, Schlichting M, Chin K, Gulley JL (2017) Avelumab, an anti-programmed death-ligand 1 antibody, in patients with refractory metastatic urothelial carcinoma: results from a multicenter, phase Ib study. J Clin Oncol 35(19):2117–2124. https://doi.org/10.1200/jco.2016.71.6795
Bellmunt J, de Wit R, Vaughn DJ, Fradet Y, Lee J-L, Fong L, Vogelzang NJ, Climent MA, Petrylak DP, Choueiri TK, Necchi A, Gerritsen W, Gurney H, Quinn DI, Culine S, Sternberg CN, Mai Y, Poehlein CH, Perini RF, Bajorin DF (2017) Pembrolizumab as second-line therapy for advanced urothelial carcinoma. N Engl J Med 376(11):1015–1026. https://doi.org/10.1056/nejmoa1613683
Balar AV, Galsky MD, Rosenberg JE, Powles T, Petrylak DP, Bellmunt J, Loriot Y, Necchi A, Hoffman-Censits J, Perez-Gracia JL, Dawson NA, van der Heijden MS, Dreicer R, Srinivas S, Retz MM, Joseph RW, Drakaki A, Vaishampayan UN, Sridhar SS, Quinn DI, Durán I, Shaffer DR, Eigl BJ, Grivas PD, Yu EY, Li S, Kadel EE, Boyd Z, Bourgon R, Hegde PS, Mariathasan S, Thåström A, Abidoye OO, Fine GD, Bajorin DF (2017) Atezolizumab as first-line treatment in cisplatin-ineligible patients with locally advanced and metastatic urothelial carcinoma: a single-arm, multicentre, phase 2 trial. Lancet 389(10064):67–76. https://doi.org/10.1016/S0140-6736(16)32455-2
Balar AV, Castellano DE, O’Donnell PH, Grivas P, Vuky J, Powles T, Plimack ER, Hahn NM, Wit RD, Pang L, Savage M, Perini RF, Keefe SM, Bajorin DF, Bellmunt J (2017) Pembrolizumab as first-line therapy in cisplatin-ineligible advanced urothelial cancer: results from the total KEYNOTE-052 study population. J Clin Oncol 35(6_suppl):284. https://doi.org/10.1200/jco.2017.35.6_suppl.284
Loriot Y, Rosenberg JE, Powles TB, Necchi A, Hussain S, Morales R, Retz M, Niegisch G, Duran I, Theodore C, Perez-Gracia JL, Grande Pulido E, Thåström A, Danner B, Mariathasan S, Abidoye O, van der Heijden M (2016) Atezolizumab (atezo) in platinum (plat)-treated locally advanced/metastatic urothelial carcinoma (mUC): updated OS, safety and biomarkers from the Ph II IMvigor210 study. Ann Oncol 27(suppl_6):783P–783P. https://doi.org/10.1093/annonc/mdw373.11
Petrylak DP, Powles T, Bellmunt J, Braiteh FS, Loriot Y, Zambrano CC, Burris HA, Kim JW, S-lM Teng, Bruey J-M, Hegde P, Abidoye OO, Vogelzang NJ (2015) A phase Ia study of MPDL3280A (anti-PDL1): updated response and survival data in urothelial bladder cancer (UBC). J Clin Oncol 33(15_suppl):4501. https://doi.org/10.1200/jco.2015.33.15_suppl.4501
Powles T, Eder JP, Fine GD, Braiteh FS, Loriot Y, Cruz C, Bellmunt J, Burris HA, Petrylak DP, S-l Teng, Shen X, Boyd Z, Hegde PS, Chen DS, Vogelzang NJ (2014) MPDL3280A (anti-PD-L1) treatment leads to clinical activity in metastatic bladder cancer. Nature 515:558. https://doi.org/10.1038/nature13904
Choi W, Porten S, Kim S, Willis D, Plimack Elizabeth R, Hoffman-Censits J, Roth B, Cheng T, Tran M, Lee IL, Melquist J, Bondaruk J, Majewski T, Zhang S, Pretzsch S, Baggerly K, Siefker-Radtke A, Czerniak B, Dinney Colin PN, McConkey David J (2014) Identification of distinct basal and luminal subtypes of muscle-invasive bladder cancer with different sensitivities to frontline chemotherapy. Cancer Cell 25(2):152–165. https://doi.org/10.1016/j.ccr.2014.01.009
Powles T, Durán I, van der Heijden MS, Loriot Y, Vogelzang NJ, De Giorgi U, Oudard S, Retz MM, Castellano D, Bamias A, Fléchon A, Gravis G, Hussain S, Takano T, Leng N, Kadel EE, Banchereau R, Hegde PS, Mariathasan S, Cui N, Shen X, Derleth CL, Green MC, Ravaud A (2018) Atezolizumab versus chemotherapy in patients with platinum-treated locally advanced or metastatic urothelial carcinoma (IMvigor211): a multicentre, open-label, phase 3 randomised controlled trial. Lancet 391(10122):748–757. https://doi.org/10.1016/S0140-6736(17)33297-X
Sharma P, Callahan MK, Bono P, Kim J, Spiliopoulou P, Calvo E, Pillai RN, Ott PA, de Braud F, Morse M, Le DT, Jaeger D, Chan E, Harbison C, Lin C-S, Tschaika M, Azrilevich A, Rosenberg JE (2016) Nivolumab monotherapy in recurrent metastatic urothelial carcinoma (CheckMate 032): a multicentre, open-label, two-stage, multi-arm, phase 1/2 trial. Lancet Oncol 17(11):1590–1598. https://doi.org/10.1016/S1470-2045(16)30496-X
Bajorin DF, Wit RD, Vaughn DJ, Fradet Y, Lee J-L, Fong L, Vogelzang NJ, Climent MÁ, Petrylak DP, Choueiri TK, Necchi A, Gerritsen W, Gurney H, Quinn DI, Culine S, Sternberg CN, Mai Y, Puhlmann M, Perini RF, Bellmunt J (2017) Planned survival analysis from KEYNOTE-045: phase 3, open-label study of pembrolizumab (pembro) versus paclitaxel, docetaxel, or vinflunine in recurrent, advanced urothelial cancer (UC). J Clin Oncol 35(15_suppl):4501. https://doi.org/10.1200/jco.2017.35.15_suppl.4501
de Wit R, Vaughn D, Fradet Y, Lee J, Fong L, Vogelzang N, Climent M, Petrylak D, Choueiri T, Necchi A, Gerritsen W, Gurney H, Quinn D, Culine S, Sternberg C, Mai Y, Puhlmann M, Perini R, Bellmunt J, Bajorin DF (2017) Pembrolizumab-pembro-versus-paclitaxel-docetaxel-or-vinflunine-for-recurrent-advanced-urothelial-cancer-UC-mature-results-from-the-phase-3-KEYNOTE-045-trial. Ann Oncol 28(suppl_5):v605–v649. https://doi.org/10.1093/annonc/mdx440
O’Donnell PH, Grivas P, Balar AV, Bellmunt J, Vuky J, Powles T, Plimack ER, Hahn NM, Wit RD, Pang L, Savage MJ, Lunceford JK, Keefe SM, Bajorin DF, Castellano D (2017) Biomarker findings and mature clinical results from KEYNOTE-052: first-line pembrolizumab (pembro) in cisplatin-ineligible advanced urothelial cancer (UC). J Clin Oncol 35(15_suppl):4502. https://doi.org/10.1200/jco.2017.35.15_suppl.4502
Plimack ER, Bellmunt J, Gupta S, Berger R, Chow LQM, Juco J, Lunceford J, Saraf S, Perini RF, O’Donnell PH (2017) Safety and activity of pembrolizumab in patients with locally advanced or metastatic urothelial cancer (KEYNOTE-012): a non-randomised, open-label, phase 1b study. Lancet Oncol 18(2):212–220. https://doi.org/10.1016/s1470-2045(17)30007-4
Apolo AB, Ellerton JA, Infante JR, Agrawal M, Gordon MS, Aljumaily R, Britten CD, Dirix LY, Lee K-W, Taylor MH, Schöffski P, Wang D, Ravaud A, Gelb A, Xiong J, Rosen G, Patel MR (2017) Updated efficacy and safety of avelumab in metastatic urothelial carcinoma (mUC): Pooled analysis from 2 cohorts of the phase 1b Javelin solid tumor study. Journal of Clinical Oncology 35(15_suppl):4528. https://doi.org/10.1200/jco.2017.35.15_suppl.4528
Massard C, Gordon MS, Sharma S (2016) Safety and efficacy of durvalumab (MEDI4736), an anti-programmed cell death ligand-1 immune checkpoint inhibitor, in patients with advanced urothelial bladder cancer. J Clin Oncol 34:3119–3125. https://doi.org/10.1200/jco.2016.67.9761
Leach DR, Krummel MF, Allison JP (1996) Enhancement of antitumor immunity by CTLA-4 blockade. Science 271(5256):1734–1736. https://doi.org/10.1126/science.271.5256.1734
Galsky MD, Wang H, Hahn NM, Twardowski P, Pal SK, Albany C, Fleming MT, Starodub A, Hauke RJ, Yu M, Zhao Q, Sonpavde G, Donovan MJ, Patel VG, Sfakianos JP, Domingo-Domenech J, Oh WK, Akers N, Losic B, Gnjatic S, Schadt EE, Chen R, Kim-Schulze S, Bhardwaj N, Uzilov AV (2018) Phase 2 trial of gemcitabine, cisplatin, plus ipilimumab in patients with metastatic urothelial cancer and impact of DNA damage response gene mutations on outcomes. Eur Urol 73(5):751–759. https://doi.org/10.1016/j.eururo.2017.12.001
Herbst RS, Gordon MS, Fine GD, Sosman JA, Soria J-C, Hamid O, Powderly JD, Burris HA, Mokatrin A, Kowanetz M, Leabman M, Anderson M, Chen DS, Hodi FS (2013) A study of MPDL3280A, an engineered PD-L1 antibody in patients with locally advanced or metastatic tumors. Journal of Clinical Oncology 31(15_suppl):3000. https://doi.org/10.1200/jco.2013.31.15_suppl.3000
Schwamborn K, Knüchel R, Hartmann A, Baretton G, Lasitschka F, Schirmacher P, Braunschweig T, Tauber R, Erlmeier F, Hieke-Schulz S, Ammann J, Weichert W (2017) Comparability-of-programmed-death-ligand-1-PD-L1-expression-on-tumor-infiltrating-immune-cells-IC-and-tumor-cells-TC-in-advanced-urothelial-bladder-cancer-UBC-using-clinically-relevant-immunohistochemistry-IHC-assays. Ann Oncol 28(suppl_5):v403–v427. https://doi.org/10.1093/annonc/mdx376
Kato S, Goodman A, Walavalkar V, Barkauskas DA, Sharabi A, Kurzrock R (2017) Hyperprogressors after Immunotherapy: analysis of genomic alterations associated with accelerated growth rate. Clin Cancer Res 23(15):4242–4250. https://doi.org/10.1158/1078-0432.ccr-16-3133
Rizvi NA, Hellmann MD, Snyder A, Kvistborg P, Makarov V, Havel JJ, Lee W, Yuan J, Wong P, Ho TS, Miller ML, Rekhtman N, Moreira AL, Ibrahim F, Bruggeman C, Gasmi B, Zappasodi R, Maeda Y, Sander C, Garon EB, Merghoub T, Wolchok JD, Schumacher TN, Chan TA (2015) Mutational landscape determines sensitivity to PD-1 blockade in non-small cell lung cancer. Science 348(6230):124–128. https://doi.org/10.1126/science.aaa1348
Apolo AB, Mortazavi A, Stein MN, Pal SK, Davarpanah NN, Parnes HL, Ning YM, Francis DC, Cordes LM, Monk P, Lancaster T, Costello R, Nanda S, Bottaro DP, Wright JJ, Streicher H, Steinberg SM, Berninger M, Lindenberg L, Dahut WL (2017) A phase I study of cabozantinib plus nivolumab (CaboNivo) and ipilimumab (CaboNivoIpi) in patients (pts) with refractory metastatic urothelial carcinoma (mUC) and other genitourinary (GU) tumors. J Clin Oncol 35(6_suppl):293. https://doi.org/10.1200/jco.2017.35.6_suppl.293
Colli LM, Machiela MJ, Myers TA, Jessop L, Yu K, Chanock SJ (2016) Burden of nonsynonymous mutations among TCGA cancers and candidate immune checkpoint inhibitor responses. Can Res 76(13):3767–3772. https://doi.org/10.1158/0008-5472.can-16-0170
Cancer Genome Atlas Research Network (2014) Comprehensive molecular characterization of urothelial bladder carcinoma. Nature 507(7492):315–322. https://doi.org/10.1038/nature12965
McGranahan N, Furness AJS, Rosenthal R, Ramskov S, Lyngaa R, Saini SK, Jamal-Hanjani M, Wilson GA, Birkbak NJ, Hiley CT, Watkins TBK, Shafi S, Murugaesu N, Mitter R, Akarca AU, Linares J, Marafioti T, Henry JY, Van Allen EM, Miao D, Schilling B, Schadendorf D, Garraway LA, Makarov V, Rizvi NA, Snyder A, Hellmann MD, Merghoub T, Wolchok JD, Shukla SA, Wu CJ, Peggs KS, Chan TA, Hadrup SR, Quezada SA, Swanton C (2016) Clonal neoantigens elicit T cell immunoreactivity and sensitivity to immune checkpoint blockade. Science (New York, NY) 351(6280):1463–1469. https://doi.org/10.1126/science.aaf1490
Buchbinder EI, Desai A (2016) CTLA-4 and PD-1 pathways: similarities, differences, and implications of their inhibition. Am J Clin Oncol 39(1):98–106. https://doi.org/10.1097/coc.0000000000000239
Snyder A, Nathanson T, Funt SA, Ahuja A, Buros Novik J, Hellmann MD, Chang E, Aksoy BA, Al-Ahmadie H, Yusko E, Vignali M, Benzeno S, Boyd M, Moran M, Iyer G, Robins HS, Mardis ER, Merghoub T, Hammerbacher J, Rosenberg JE, Bajorin DF (2017) Contribution of systemic and somatic factors to clinical response and resistance to PD-L1 blockade in urothelial cancer: an exploratory multi-omic analysis. PLoS Med 14(5):e1002309. https://doi.org/10.1371/journal.pmed.1002309
Galsky MD, Saci A, Szabo PM, Azrilevich A, Horak C, Lambert A, Siefker-Radtke A, Necchi A, Sharma P (2017) Impact of tumor mutation burden on nivolumab efficacy in second-line urothelial carcinoma patients: exploratory analysis of the phase II checkmate 275 study. Ann Oncol 28(suppl_5):v295–v329. https://doi.org/10.1093/annonc/mdx371.003
Snyder A, Makarov V, Merghoub T, Yuan J, Zaretsky JM, Desrichard A, Walsh LA, Postow MA, Wong P, Ho TS, Hollmann TJ, Bruggeman C, Kannan K, Li Y, Elipenahli C, Liu C, Harbison CT, Wang L, Ribas A, Wolchok JD, Chan TA (2014) Genetic basis for clinical response to CTLA-4 blockade in melanoma. N Engl J Med 371(23):2189–2199. https://doi.org/10.1056/nejmoa1406498
Chalmers ZR, Connelly CF, Fabrizio D, Gay L, Ali SM, Ennis R, Schrock A, Campbell B, Shlien A, Chmielecki J, Huang F, He Y, Sun J, Tabori U, Kennedy M, Lieber DS, Roels S, White J, Otto GA, Ross JS, Garraway L, Miller VA, Stephens PJ, Frampton GM (2017) Analysis of 100,000 human cancer genomes reveals the landscape of tumor mutational burden. Genome Med 9(1):34. https://doi.org/10.1186/s13073-017-0424-2
Le DT, Uram JN, Wang H, Bartlett BR, Kemberling H, Eyring AD, Skora AD, Luber BS, Azad NS, Laheru D, Biedrzycki B, Donehower RC, Zaheer A, Fisher GA, Crocenzi TS, Lee JJ, Duffy SM, Goldberg RM, de la Chapelle A, Koshiji M, Bhaijee F, Huebner T, Hruban RH, Wood LD, Cuka N, Pardoll DM, Papadopoulos N, Kinzler KW, Zhou S, Cornish TC, Taube JM, Anders RA, Eshleman JR, Vogelstein B, Diaz LAJ (2015) PD-1 blockade in tumors with mismatch-repair deficiency. N Engl J Med 372(26):2509–2520. https://doi.org/10.1056/nejmoa1500596
Diaz LA, Le DT, Yoshino T, Andre T, Bendell JC, Koshiji M, Zhang Y, Kang SP, Lam B, Jäger D (2017) KEYNOTE-177: randomized phase III study of pembrolizumab versus investigator-choice chemotherapy for mismatch repair-deficient or microsatellite instability-high metastatic colorectal carcinoma. J Clin Oncol 35(4_suppl):TPS815. https://doi.org/10.1200/jco.2017.35.4_suppl.tps815
Nalley C (2017) FDA approves first cancer treatment for any solid tumor with specific biomarker. Oncol Times 39(13):52–53
Pal SK, Agarwal N, Choueiri TK, Stephens PJ, Ross JS, Miller VA, Ali SA, Chung J, Grivas P (2017) Comparison of tumor mutational burden (TMB) in relevant molecular subsets of metastatic urothelial cancer (MUC). Ann Oncol 28(suppl_5):v295–v329. https://doi.org/10.1093/annonc/mdx371.004
Johanns TM, Miller CA, Dorward IG, Tsien C, Chang E, Perry A, Uppaluri R, Ferguson C, Schmidt RE, Dahiya S, Ansstas G, Mardis ER, Dunn GP (2016) Immunogenomics of hypermutated glioblastoma: a patient with germline POLE deficiency treated with checkpoint blockade immunotherapy. Cancer Discov 6(11):1230–1236. https://doi.org/10.1158/2159-8290.cd-16-0575
Powles T, Loriot Y, Ravaud A, Vogelzang NJ, Duran I, Retz M, Giorgi UD, Oudard S, Bamias A, Koeppen H, Leng N, Kadel EE, Hegde PS, Cui N, Shen X, Derleth CL, Green MC, Banchereau R, Mariathasan S, Heijden MSVD (2018) Atezolizumab (atezo) vs. chemotherapy (chemo) in platinum-treated locally advanced or metastatic urothelial carcinoma (mUC): Immune biomarkers, tumor mutational burden (TMB), and clinical outcomes from the phase III IMvigor211 study. J Clin Oncol 36(6_suppl):409. https://doi.org/10.1200/jco.2018.36.6_suppl.409
Necchi A, Briganti A, Raggi D, Giannatempo P, Mariani L, Messina A, Anichini A, Calareso G, Crippa F, Catanzaro M, Fossati N, Gandaglia G, Salonia A, Salvioni R, Montorsi F (2018) Interim results from PURE-01: a phase 2, open-label study of neoadjuvant pembrolizumab (pembro) before radical cystectomy for muscle-invasive urothelial bladder carcinoma (MIUC). J Clin Oncol 36(6_suppl):TPS533. https://doi.org/10.1200/jco.2018.36.6_suppl.tps533
Necchi A (2018) Preoperative pembrolizumab (pembro) before radical cystectomy (RC) for muscle-invasive urothelial bladder carcinoma (MIUC): interim clinical and biomarker findings from the phase 2 PURE-01 study. J Clin Oncol 36(suppl):4507 (abstr 4507)
Powles T (2018) A phase II study investigating the safety and efficacy of neoadjuvant atezolizumab in muscle invasive bladder cancer (ABACUS). J Clin Oncol 36(suppl):4506 (abstr 4506)
Gajewski TF, Schreiber H, Fu Y-X (2013) Innate and adaptive immune cells in the tumor microenvironment. Nat Immunol 14(10):1014–1022. https://doi.org/10.1038/ni.2703
Ikeda H, Old LJ, Schreiber RD (2002) The roles of IFNγ in protection against tumor development and cancer immunoediting. Cytokine Growth Factor Rev 13(2):95–109. https://doi.org/10.1016/S1359-6101(01)00038-7
Sharma P, Allison JP (2015) The future of immune checkpoint therapy. Science 348(6230):56–61. https://doi.org/10.1126/science.aaa8172
Jamieson NB, Maker AV (2017) Gene-expression profiling to predict responsiveness to immunotherapy. Cancer Gene Ther 24(3):134–140. https://doi.org/10.1038/cgt.2016.63
Tumeh PC, Harview CL, Yearley JH, Shintaku IP, Taylor EJM, Robert L, Chmielowski B, Spasic M, Henry G, Ciobanu V, West AN, Carmona M, Kivork C, Seja E, Cherry G, Gutierrez AJ, Grogan TR, Mateus C, Tomasic G, Glaspy JA, Emerson RO, Robins H, Pierce RH, Elashoff DA, Robert C, Ribas A (2014) PD-1 blockade induces responses by inhibiting adaptive immune resistance. Nature 515(7528):568–571. https://doi.org/10.1038/nature13954
Daud AI, Loo K, Pauli ML, Sanchez-Rodriguez R, Sandoval PM, Taravati K, Tsai K, Nosrati A, Nardo L, Alvarado MD, Algazi AP, Pampaloni MH, Lobach IV, Hwang J, Pierce RH, Gratz IK, Krummel MF, Rosenblum MD (2016) Tumor immune profiling predicts response to anti-PD-1 therapy in human melanoma. J Clin Investig 126(9):3447–3452. https://doi.org/10.1172/jci87324
Loo K, Tsai KK, Mahuron K, Liu J, Pauli ML, Sandoval PM, Nosrati A, Lee J, Chen L, Hwang J, Levine LS, Krummel MF, Algazi AP, Alvarado MD, Rosenblum MD, Daud AI (2017) Partially exhausted tumor-infiltrating lymphocytes predict response to combination immunotherapy. JCI Insight 2(14):e93433. https://doi.org/10.1172/jci.insight.93433
Garcia-Diaz A, Shin DS, Moreno BH, Saco J, Escuin-Ordinas H, Rodriguez GA, Zaretsky JM, Sun L, Hugo W, Wang X, Parisi G, Saus CP, Torrejon DY, Graeber TG, Comin-Anduix B, Hu-Lieskovan S, Damoiseaux R, Lo RS, Ribas A (2017) Interferon receptor signaling pathways regulating PD-L1 and PD-L2 expression. Cell Rep 19(6):1189–1201. https://doi.org/10.1016/j.celrep.2017.04.031
Ayers M, Lunceford J, Nebozhyn M, Murphy E, Loboda A, Kaufman DR, Albright A, Cheng JD, Kang SP, Shankaran V, Piha-Paul SA, Yearley J, Seiwert TY, Ribas A, McClanahan TK (2017) IFN-γ-related mRNA profile predicts clinical response to PD-1 blockade. J Clin Investig 127(8):2930–2940. https://doi.org/10.1172/jci91190
Wallden B, Pekker I, Popa S, Dowidar N, Sullivan A, Hood T, Danaher P, Mashadi-Hossein A, Lunceford JK, Marton MJ, Chang KCN, Ferree S, Storhoff JJ (2016) Development and analytical performance of a molecular diagnostic for anti-PD1 response on the nCounter Dx analysis system. J Clin Oncol 34(15_suppl):3034. https://doi.org/10.1200/jco.2016.34.15_suppl.3034
Sharma P, Shen Y, Wen S, Yamada S, Jungbluth AA, Gnjatic S, Bajorin DF, Reuter VE, Herr H, Old LJ, Sato E (2007) CD8 tumor-infiltrating lymphocytes are predictive of survival in muscle-invasive urothelial carcinoma. Proc Natl Acad Sci USA 104(10):3967–3972. https://doi.org/10.1073/pnas.0611618104
Higgs BW, Morehouse CA, Streicher K, Brohawn PZ, Pilataxi F, Gupta A, Ranade K (2018) Interferon gamma messenger RNA signature in tumor biopsies predicts outcomes in patients with non-small cell lung carcinoma or urothelial cancer treated with durvalumab. Clin Cancer Res 24(16):3857–3866. https://doi.org/10.1158/1078-0432.ccr-17-3451
The Cancer Genome Atlas Research Network (2014) Comprehensive molecular characterization of urothelial bladder carcinoma. Nature 507:315. https://doi.org/10.1038/nature12965. https://www.nature.com/articles/nature12965#supplementary-information
Herbst RS, Soria J-C, Kowanetz M, Fine GD, Hamid O, Gordon MS, Sosman JA, McDermott DF, Powderly JD, Gettinger SN, Kohrt HEK, Horn L, Lawrence DP, Rost S, Leabman M, Xiao Y, Mokatrin A, Koeppen H, Hegde PS, Mellman I, Chen DS, Hodi FS (2014) Predictive correlates of response to the anti-PD-L1 antibody MPDL3280A in cancer patients. Nature 515(7528):563–567. https://doi.org/10.1038/nature14011
Lerner SP, McConkey DJ, Hoadley KA, Chan KS, Kim WY, Radvanyi F, Höglund M, Real FX (2016) Bladder cancer molecular taxonomy: summary from a consensus meeting. Bladder Cancer 2(1):37–47. https://doi.org/10.3233/blc-150037
Sjödahl G, Lauss M, Lövgren K, Chebil G, Gudjonsson S, Veerla S, Patschan O, Aine M, Fernö M, Ringnér M, Månsson W, Liedberg F, Lindgren D, Höglund M (2012) A molecular taxonomy for urothelial carcinoma. Clin Cancer Res 18(12):3377–3386. https://doi.org/10.1158/1078-0432.ccr-12-0077-t
Author information
Authors and Affiliations
Contributions
Project development: JB, VS. Data collection and management: VS, JMM, IAC. Data analysis: VS, JB, TT, JB. Manuscript writing and editing: all authors.
Corresponding author
Ethics declarations
Conflict of interest
Bedke: honoraria/research funding: AstraZeneca, Astellas, BMS, MSD, Pfizer, Roche; Stenzl: honoraria/research funding: BMS, MSD, Pfizer, Roche; Todenhöfer: BMS, MSD, Roche
Rights and permissions
About this article
Cite this article
Stühler, V., Maas, J.M., Bochem, J. et al. Molecular predictors of response to PD-1/PD-L1 inhibition in urothelial cancer. World J Urol 37, 1773–1784 (2019). https://doi.org/10.1007/s00345-018-2538-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00345-018-2538-6