Dr. Balar on Immunotherapy in Bladder Cancer

Arjun Balar, MD, assistant professor of medicine, Division of Hematology & Oncology, New York University Cancer Institute, NYU Langone Medical Center, discusses the potential of immunotherapy agents as treatment for bladder cancer.

Balar says immunotherapy has been apart of bladder cancer for a long time, especially in superficial bladder cancer, where intravesical Bacillus Calmette-Guerin (BCG) therapy is used in patients with non-muscle invasive high-grade carcinoma in situ. As the standard of care, this approach reduces risk of relapse and improves survival.

A pre-surgical trial that was lead by Padmanee Sharma, MD, PhD, at MD Anderson Cancer Center, studied the efficacy of ipilimumab in patients before receiving radical cystectomy for invasive bladder cancer, Balar says. The results showed that there was a robust infiltration of T cells inside the tumor, suggesting that ipilimumab had a significant response in regards to infiltration of T cells. Ipilimumab is now being studied in the metastatic setting in combination with chemotherapy, Balar says, but there is not any robust prospective data.

Balar says there are no agents targeting PD-1 currently in development for the treatment of bladder cancer.