Combination of Chemo and Immunotherapy Is Shown to Work Against Metastatic Bladder Cancer
A clinical trial led by Mount Sinai researchers has showed for the first time that combining chemotherapy and immunotherapy can slow down metastatic bladder cancer. The trial also showed that immunotherapy alone may be an option for a subset of patients with metastatic bladder cancer if their tumor expresses a high level of a protein called PD-L1 according to the study, published in The Lancet in May.
This randomized, Phase 3 clinical trial, named IMvigor130, measured 1,213 patients’ response to chemotherapy—either gemcitabine plus cisplatin or gemcitabine plus carboplatin—and the immunotherapy drug atezolizumab versus chemotherapy alone or atezolizumab alone.
“This is the first study to show that combining chemotherapy and immunotherapy significantly delays progression of metastatic bladder cancer compared with chemotherapy alone, and the first randomized study to contextualize the use of immunotherapy alone as a first-line treatment option for patients with metastatic bladder cancer based on expression of the PD-L1 protein,” said lead author Matthew Galsky, MD, Co-Director of the Center of Excellence for Bladder Cancer at The Tisch Cancer Institute and Professor of Medicine at the Icahn School of Medicine at Mount Sinai.
The trial data has already changed whether doctors use immunotherapy or chemotherapy alone for a subset of patients by screening patients to see the level of PD-L1 present in their tumors. The trial may support using the combination of chemotherapy with immunotherapy as a standard treatment for metastatic bladder cancer once final results are available.
This trial was sponsored by F. Hoffmann-La Roche and Genentech.
About the Mount Sinai Health System
Mount Sinai Health System is one of the largest academic medical systems in the New York metro area, with more than 43,000 employees working across eight hospitals, over 400 outpatient practices, nearly 300 labs, a school of nursing, and a leading school of medicine and graduate education. Mount Sinai advances health for all people, everywhere, by taking on the most complex health care challenges of our time — discovering and applying new scientific learning and knowledge; developing safer, more effective treatments; educating the next generation of medical leaders and innovators; and supporting local communities by delivering high-quality care to all who need it.
Through the integration of its hospitals, labs, and schools, Mount Sinai offers comprehensive health care solutions from birth through geriatrics, leveraging innovative approaches such as artificial intelligence and informatics while keeping patients’ medical and emotional needs at the center of all treatment. The Health System includes approximately 7,300 primary and specialty care physicians; 13 joint-venture outpatient surgery centers throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and more than 30 affiliated community health centers. We are consistently ranked by U.S. News & World Report's Best Hospitals, receiving high "Honor Roll" status, and are highly ranked: No. 1 in Geriatrics and top 20 in Cardiology/Heart Surgery, Diabetes/Endocrinology, Gastroenterology/GI Surgery, Neurology/Neurosurgery, Orthopedics, Pulmonology/Lung Surgery, Rehabilitation, and Urology. New York Eye and Ear Infirmary of Mount Sinai is ranked No. 12 in Ophthalmology. U.S. News & World Report’s “Best Children’s Hospitals” ranks Mount Sinai Kravis Children's Hospital among the country’s best in 4 out of 10 pediatric specialties. The Icahn School of Medicine at Mount Sinai is one of three medical schools that have earned distinction by multiple indicators: It is consistently ranked in the top 20 by U.S. News & World Report's "Best Medical Schools," aligned with a U.S. News & World Report "Honor Roll" Hospital, and top 20 in the nation for National Institutes of Health funding and top 5 in the nation for numerous basic and clinical research areas. Newsweek’s “The World’s Best Smart Hospitals” ranks The Mount Sinai Hospital as No. 1 in New York and in the top five globally, and Mount Sinai Morningside in the top 20 globally.