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
The Mount Sinai Health System is New York City's largest academic medical system, encompassing eight hospitals, a leading medical school, and a vast network of ambulatory practices throughout the greater New York region. Mount Sinai is a national and international source of unrivaled education, translational research and discovery, and collaborative clinical leadership ensuring that we deliver the highest quality care—from prevention to treatment of the most serious and complex human diseases. The Health System includes more than 7,200 physicians and features a robust and continually expanding network of multispecialty services, including more than 400 ambulatory practice locations throughout the five boroughs of New York City, Westchester, and Long Island. The Mount Sinai Hospital is ranked No. 14 on U.S. News & World Report's "Honor Roll" of the Top 20 Best Hospitals in the country and the Icahn School of Medicine as one of the Top 20 Best Medical Schools in country. Mount Sinai Health System hospitals are consistently ranked regionally by specialty and our physicians in the top 1% of all physicians nationally by U.S. News & World Report.