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BLADDER CANCER IN 2018

Refining existing knowledge and management of bladder cancer

  • Year in Review
  • Published:

From Nature Reviews Urology

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For the management of bladder cancer, 2018 has been characterized by deepened knowledge on the molecular basis of invasive bladder cancer and its potential interaction with existing therapies, optimization of the use of immune checkpoint inhibitors, and emerging early signals on new therapeutic classes for advanced disease.

Key advances

  • The Cancer Genome Atlas performed a comprehensive characterization of muscle-invasive bladder cancer (MIBC) in a large cohort and proposed a framework of molecular subtypes with potential therapeutic approaches to inform future clinical trial design1.

  • The phase III RAZOR trial reported noninferior 2-year progression-free survival between robot-assisted radical cystectomy and open radical cystectomy2.

  • The phase II PURE-01 study reported that patients with MIBC and high programmed cell death 1 ligand 1 (PD-L1) expression had the highest response rates to neoadjuvant pembrolizumab5, warranting further evaluation in larger cohorts.

  • The phase III IMvigor211 trial did not report an overall survival benefit with atezolizumab over cytotoxic chemotherapy in locally advanced or metastatic urothelial carcinoma7.

  • Preliminary phase II findings demonstrated the efficacy of the fibroblast growth factor receptor 3 (FGFR3) inhibitor erdafitinib in metastatic urothelial cancer, leading to FDA Breakthrough Therapy Status for this drug10.

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Fig. 1: Current treatment paradigms for advanced bladder and urothelial cancer.

References

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  2. Parekh, D. J. et al. Robot-assisted radical cystectomy versus open radical cystectomy in patients with bladder cancer (RAZOR): an open-label, randomised, phase 3, non-inferiority trial. Lancet 391, 2525–2536 (2018).

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  10. Siefker-Radtke, A. O. et al. First results from the primary analysis population of the phase 2 study of erdafitinib (ERDA; JNJ-42756493) in patients (pts) with metastatic or unresectable urothelial carcinoma (mUC) and FGFR alterations (FGFRalt) [abstract]. J. Clin. Oncol. 36 (Suppl. 15), 4503 (2018).

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Authors and Affiliations

  1. Genitourinary Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Min Yuen Teo & Jonathan E. Rosenberg

Authors
  1. Min Yuen Teo
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  2. Jonathan E. Rosenberg
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Corresponding author

Correspondence to Jonathan E. Rosenberg.

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Competing interests

J.E.R. has received consulting fees from Genentech/Roche, AstraZeneca, Bristol-Myers Squibb, Seattle Genetics, Merck, Bayer, EMD Serono, Astellas, Sensiei Biotherapeutics, Pharmacyclics, Inovio, Gritstone, Western Oncolytics, Bioclin, QED Therapeutics, Adicet Bio, Fortress Biotech and Mirati Research; funding (for industry trials) from Genentech/Roche, Astellas and Bayer; and research funding (investigator-initiated trials) from Novartis and Genentech/Roche. M.Y.T. has received research funding (investigator-initiated trial) from Bristol-Myers Squibb and funding (for industry trials) from Clovis Oncology.

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Teo, M.Y., Rosenberg, J.E. Refining existing knowledge and management of bladder cancer. Nat Rev Urol 16, 75–76 (2019). https://doi.org/10.1038/s41585-018-0137-3

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  • DOI: https://doi.org/10.1038/s41585-018-0137-3

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