The immune checkpoint blockade drug nivolumab reduced tumor burden in 24.4 percent of patients with metastatic bladder cancer, regardless of whether their tumors had a biomarker related to the drug’s target, according to clinical trial results from The University of Texas MD Anderson Cancer Center.
“The response rate is better than we’ve seen for other potential second-line treatments, and nivolumab is really well-tolerated, which is important because bladder cancer patients are a fragile group after frontline treatment with platinum chemotherapy,” said Padmanee Sharma, M.D., Ph.D., professor of Genitourinary Medical Oncology at MD Anderson.
Nivolumab unleashes an immune system attack on cancer by blocking activation of a protein called PD-1 on T cells, white blood cells that find and attack cells, viruses or bacteria that have specific targets. PD-1 acts as a brake, or checkpoint, to shut down activated T cells. PD-1 is turned on by a ligand called PD-L1, which is often found on cancer cells and other types of cells.
The presence of PD-L1 on a patient’s tumor has been considered a potential biomarker to guide treatment. The study found no significant difference in response rates between those with little to no PD-L1 on their tumors (26 percent) and those with greater PD-L1 expression (24 percent).
“We can get good results without choosing to treat patients based on PD-L1 status,” said Sharma, who also is scientific director of MD Anderson’s immunotherapy platform and an investigator with the Parker Institute for Cancer Immunotherapy at MD Anderson. The platform is part of MD Anderson’s Moon Shots Program, launched in 2013 to reduce cancer deaths by accelerating development of therapies, prevention efforts and early detection from scientific discoveries.
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