Saeed Rafii, MD, PhD, medical director, Sarah Cannon Research Institute, United Kingdom, discusses investigational immunotherapy approaches for the treatment of patients with bladder cancer.

Rafii envisions that there will be more clinical trials exploring anti—PD-1 agents in this field. This includes combination studies of PD-1 and CTLA-4 inhibitors, as well as basket trials studying combinations of immunotherapy with olaparib (Lynparza) and EGFR inhibitors. Another ongoing trial is looking at durvalumab compared with chemotherapy.

Results of such studies, which will be announced over the next few years, will explain whether immunotherapy will become a frontline choice and compete with chemotherapy, or could be administered as part of a combination regimen.

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Saeed Rafii, MD, PhD, medical director, Sarah Cannon Research Institute, United Kingdom, discusses novel immunotherapy approaches for the treatment of patients with bladder cancer.

Dr. Rafii on Future Immunotherapy Approaches for Patients With Bladder Cancer

Saeed Rafii, MD, PhD, medical director, Sarah Cannon Research Institute, United Kingdom, discusses a phase I/II dose-escalation and dose-expansion study examining the efficacy and safety of the PD-1 antibody durvalumab in patients with metastatic urothelial bladder cancer.

The study examined the immunotherapy agent in a variety of solid tumors, Rafii says. In the urothelial bladder cancer cohort, the overall response rate was 25% in patients with liver metastases and 50% in patients with lymph node‒only disease. Response rates to chemotherapy for patients with this disease, he adds, have generally been low.

Additionally, responses are ongoing in 15 out of 16 patients enrolled in this study. The longest duration of response is ongoing at 11.3 months.

Saeed Rafii, MD, PhD, medical director, Sarah Cannon Research Institute, United Kingdom, discusses a phase I/II dose-escalation study examining the efficacy and safety of the PD-1 antibody durvalumab in patients with metastatic urothelial bladder cancer.

Dr. Rafii on Durvalumab in Patients With Urothelial Bladder Cancer

Saeed Rafii, MD, PhD, medical director, Sarah Cannon Research Institute United Kingdom, discusses a study evaluating the safety and clinical activity of atezolizumab in combination with nab-paclitaxel in patients with metastatic triple-negative breast cancer (TNBC).

There were 24 evaluable patients in the trial, says Rafii. The confirmed response rate in TNBC was 41.7%. Investigators noted that patients who had received nab-paclitaxel and atezolizumab as a first-line treatment for metastatic TNBC had a higher response rate of 66.7%. However, this was based on a small cohort of 9 patients, explains Rafii.

There were significant hematologic toxicities seen in the study, including 40.1% of patients who developed a grade III neutropenia, 9% who developed a grade III thrombocytopenia, and 6% who developed grade II anemia.

View more from the 2015 San Antonio Breast Cancer Symposium

Dr. Saeed Rafii on Atezolizumab/ Nab-paclitaxel in TNBC

Saeed Rafii, MD, PhD, MRCP, medical director, Sarah Cannon Research Institute, discusses factors that influence clinical outcomes to olaparib in patients with 

-mutated ovarian cancer respond to treatment with olaparib, or they may have short duration of responses, Rafii explains. A study at seven institutions sought to determine baseline factors that may predict response to the PARP inhibitor.

Data showed that patients who had longer intervals between platinum chemotherapy and olaparib had higher response rates than patients with shorter intervals. Also, patients with fewer lines of treatment had a higher likelihood of responding to olaparib compared with patients with more advanced disease and more lines of treatment.

Further research is needed to determine if starting a patient on olaparib at the beginning of a treatment plan would have a greater benefit, Rafii adds.

Saeed Rafii, MD, PhD, MRCP, medical director, Sarah Cannon Research Institute, discusses factors that influence clinical outcomes to olaparib in patients with BRCA1/2-mutant ovarian cancer.

Saeed Rafii, MD, PhD

Articles

Dr. Rafii on Future Immunotherapy Approaches for Patients With Bladder Cancer

Dr. Rafii on Durvalumab in Patients With Urothelial Bladder Cancer

Dr. Saeed Rafii on Atezolizumab/ Nab-paclitaxel in TNBC

Dr. Rafii Discusses Clinical Outcomes With Olaparib in Patients with Ovarian Cancer