Dr. Flaig on Immune Checkpoint Inhibitors in Advanced Bladder Cancer

Thomas W. Flaig, MD, professor, associate dean for clinical research, Genitourinary Cancer Program, Division of Medical Oncology, University of Colorado, Denver, discusses the utility of immune checkpoint inhibitors in advanced bladder cancer.

Five checkpoint inhibitors, nivolumab (Opdivo), atezolizumab (Tecentriq), pembrolizumab (Keytruda), durvalumab (Imfinzi), and avelumab (Bavencio), are approved for patients with advanced bladder cancer.

Although this new class of drugs has revolutionized the space, single-agent checkpoint inhibitors elicit response rates of around 20% to 25%, explains Flaig. Combination strategies may increase response rates while maintaining durability and tolerability.

In terms of treatment, the majority of patients with advanced disease should receive up front chemotherapy followed by an immune checkpoint inhibitor in the second-line setting.