Dr. Gupta on BLASST-1 Results in Muscle-Invasive Bladder Cancer

Shilpa Gupta, MD, medical oncologist, Department of Hematology and Medical Oncology, Cleveland Clinic, discusses the results of the phase II BLASST-1 trial, which is evaluating nivolumab, gemcitabine, and cisplatin in patients with muscle-invasive bladder cancer who are undergoing cystectomy.

Shilpa Gupta, MD, medical oncologist, Department of Hematology and Medical Oncology, Cleveland Clinic, discusses the results of the phase II BLASST-1 trial, which is evaluating nivolumab (Opdivo), gemcitabine, and cisplatin in patients with muscle-invasive bladder cancer who are undergoing cystectomy.

The BLASST-1 trial is exploring this regimen in the neoadjuvant setting of muscle-invasive bladder cancer, explains Gupta, adding that these are patients eligible to receive cisplatin. Patients received 4 cycles of the regimen, including nivolumab on day 8 of each cycle, and then cystectomy is performed within 6 to 8 weeks. The primary endpoint was pathologic downstaging to nonmuscle-invasive disease status; secondary endpoints were progression-free survival and safety. There were also a number of exploratory endpoints, she adds.

Results showed that the downstaging rate was 66%; the pathologic complete response rate was 49%, which is said to be significant for this patient population. Additionally, patients who had cT4N1 disease had a downstaging to pTa disease, Gupta concludes.

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