Dr. Singh on Combination Therapy in Localized Bladder Cancer

Parminder Singh, MD, hematologist/oncologist, Mayo Clinic, discusses combination treatments that are being evaluated in localized bladder cancer.

The natural progression of drugs that are approved in the advanced setting is to move them into earlier stages of disease, and bladder cancer is no exception, says Singh. Several combination treatments that have been approved for use in the advanced setting are already being evaluated in the frontline space. Investigators at Mayo Clinic recently opened the SWOG 1806 trial, which is looking at the combination of chemotherapy with radiation and atezolizumab (Tecentriq) in localized bladder cancer. Several other clinical trials are combining chemoimmunotherapy in the neoadjuvant space, adds Singh.

Combinations of chemotherapy and immunotherapy are poised to move into earlier lines of therapy, but they are not the only treatment strategies with this potential, says Singh. Clinical trials combining FGFR3 inhibitors with chemotherapy in earlier-line settings are also ongoing. As the understanding of these newer agents and the comfort surrounding their use grows, there will be a natural progression of these agents into early-stage disease, concludes Singh.