Madrid, June 5 2023-. Once again, the Annual Meeting of the American Society of Clinical Oncology (ASCO) has provided a forum for the most significant scientific advances in the field of oncology. Over the four days of the conference, a number of studies were presented demonstrating important new breakthroughs and benefits for oncology patients.
On this topic, Dr. Enrique Grande, Head of the MD Anderson Cancer Center Madrid Medical Oncology Department, presented the oral session on genitourinary tumours to an audience of more than 20,000. Specifically this aimed to provide an update on the overall survival results of the IMvigor130 study, which assesses the combination of atezolizumab with chemotherapy in the first line treatment of metastatic urothelial carcinoma.
The IMvigor130 study is, to date, the area of research that has recruited the most patients with metastatic bladder cancer. “Although there are no positive results to demonstrate overall survival when chemotherapy is combined with immunotherapy, we have still learnt a great deal on how to treat bladder cancer through consultation with the more than 200 centres in 35 different countries that have participated in this study”, affirms Dr. Grande. During this session, the doctor analysed a subgroup of patients who not only received the combination of chemotherapy with immunotherapy, but also, after an initial benefit, continued to receive immunotherapy until the progression of the tumour. “In this subanalysis it was seen that the survival among this group of patients was no better than for those patients who only received chemotherapy. This data is important because it allows us to question the administration of immunotherapy treatment as a maintenance therapy following an initial induction”, warned Enrique Grande.
In addition, in a prospective manner this post-hoc analysis of the IMvigor130 study shows that patients with metastatic urothelial cancer that advances during induction chemotherapy have an ominous prognosis of scarcely 3 months of survival. “Of course, this subgroup of patients with such a poor prognosis is a need not covered under clinical practice. As such, without a doubt, we need to identify them in advance and formulate different alternatives”.
The expert added, “This data is significant as it questions the therapy used as standard today, with induction chemotherapy followed by immunotherapy for all patients showing clinical benefits”. In fact, he went on, “those patients that receive carboplatin rather than cisplatin, and those patients with a low PD-L1 expression in the immunohistochemistry of the tumour, seem not to benefit at all from these treatments”.
The impact that the IMvigor130 study has had worldwide in the treatment of patients with bladder cancer where metastasis has occurred is in the approval for the administration of one of the immunotherapies as a sole agent in the case of people who are not otherwise candidates (due to their general condition or comorbidities). They would also receive chemotherapy based on cisplatin. “I believe we can all be proud of having led a study on this scale. It is always an honour to be able to present our colleagues from all around the world with clinical results that, even if they do not change clinical practice, will certainly help us to better understand a disease so important as bladder cancer”, concluded Dr. Grande.