What’s Next for Cutting-Edge Bladder Cancer Treatment?


Dr. David Nanus, Chief of Hematology and Medical Oncology at Weill Cornell Medicine and NewYork-Prebysterian Hospital and genitourinary (GU) cancer expert, sat down with OncLive TV to discuss future research efforts and next steps for a new immunotherapy drug for patients with bladder cancer. This drug, atezolizumab (brand name Tecentriq), is the first new drug that has been FDA-approved for urothelial carcinoma – the most common type of bladder cancer – in over two decades.

Atezolizumab works by detecting a specific protein (PD-L1) on the surface of tumor cells, allowing the body’s immune system to recognize the cancer and attack it. Ongoing research on this treatment has revealed some complexities that have left physicians and researchers with questions ripe for scientific exploration, especially since this is a newer drug lacking long-term clinical data.

Two important questions remain regarding atezolizumab:

1. Are there biomarkers we can use for this drug?
2. For how long should this drug be administered?

The first question involves “biomarkers” or “biological markers,” indicators in the body that can be measured or tracked. In cancer treatment, oncologists use different biomarkers to glean information about a patient’s diagnosis and prognosis, as well as to monitor treatment effectiveness. Biomarkers can also offer information about safety of a treatment and signal which patients will benefit most from a certain drug. Currently, we do not yet have any biomarkers to predict whether atezolizumab will work. In a recent interview with OncLive TV, Dr. Nanus explains this uncertainty by saying, “There is not going to be one simple biomarker that is going to say to treat or not treat, so that is the unanswered question.”

The second question pertains to duration of treatment. Researchers and physicians are still working to find out when atezolizumab can be safely stopped without losing its benefit, and if the drug can be re-administered in the case of cancer recurrence or relapse. The “right” length of treatment is also linked with cost-effectiveness and accessibility for all patients in need since this drug is very expensive.

These questions are global issues that pertain to many new and emerging cancer treatments, especially immunotherapies that leverage the body’s own immune system to fight the tumors. Immunotherapies are drastically changing the way many cancers are treated, but we still have much more to learn. It is only with time and additional research that we will find the answers to both of these questions.

Hear from Dr. Nanus firsthand:

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