Dr. Schmid on Next Steps for the RACE IT Trial in Urothelial Carcinoma

Sebastian C. Schmid, MD, oncologist, Rechts der Isar Medical Center, Technical University of Munich, Germany, discusses the future of the phase 2 RACE IT trial (NCT03529890) in urothelial carcinoma.

RACE IT evaluated preoperative radiation therapy plus nivolumab (Opdivo) prior to radical cystectomy in patients with locally advanced urothelial carcinoma.

With updated findings from the phase 2 trial, it will be important to examine data on quality of life for enrolled patients, Schmid says. Additional planned research will deliver more detailed data on adverse effects, Schmid adds.

Furthermore, translational projects will explore possible predictive markers for radiation therapy. There are several ways that RACE IT could provide additional valuable data, Schmid concludes.

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Sebastian C. Schmid, MD, discusses the future of the phase 2 RACE IT trial in urothelial carcinoma. 

Sebastian C. Schmid, MD, oncologist, Rechts der Isar Medical Center, Technical University of Munich, Germany, discusses the rationale for the phase 2 RACE IT trial (NCT03529890) in urothelial carcinoma.

Preoperative radiation therapy plus nivolumab (Opdivo) prior to radical cystectomy was evaluated in the phase 2 RACE IT trial in patients with locally advanced urothelial carcinoma.

This trial investigated a population of patients that have a poor prognosis. For example, patients from this population who are treated with surgery alone have survival rates as low as 20% to 30%, Schmid explains. Moreover, this patient population doesn’t benefit substantially from neoadjuvant chemotherapy, leaving room for improvement, Schmid adds.

Checkpoint inhibitors in combination with radiation therapy could lead to improved outcomes in this population, Schmid continues. Radiation therapy has an immunostimulating effect, boosting the activity of checkpoint inhibitors. There are also immune depressing effects associated with radiation that can be counteracted by immune checkpoint inhibitors, Schmid concludes.

Sebastian C. Schmid, MD, discusses the rationale for the phase 2 RACE IT trial in urothelial carcinoma.


Dr. Schmid on the Rationale for the RACE IT Trial in Advanced Urothelial Carcinoma

Sebastian C. Schmid, MD, oncologist, Rechts der Isar Medical Center, Technical University of Munich, Germany, discusses the use of preoperative radiation therapy plus immunotherapy in urothelial carcinoma.

Preoperative radiation therapy plus nivolumab (Opdivo) prior to radical cystectomy was evaluated in the phase 2 RACE IT trial (NCT03529890) in patients with locally advanced urothelial carcinoma.

Findings from this study showed that the effectiveness of radioimmunotherapy is independent of kidney function, which is notable for patients with urothelial carcinoma since many experience kidney problems, Schmid explains.

The next step in researching the efficacy of radioimmunotherapy in this patient population will involve comparing the combination to immunotherapy alone, Schmid says. Prospective phase 3 trials are needed to further understand how the treatments compare, Schmid concludes.

Sebastian C. Schmid, MD, discusses the use of preoperative radiation therapy plus immunotherapy in urothelial carcinoma.


Sebastian C. Schmid, MD

Articles

Dr. Schmid on Next Steps for the RACE IT Trial in Urothelial Carcinoma

Dr. Schmid on the Rationale for the RACE IT Trial in Advanced Urothelial Carcinoma

Dr. Schmid on the Use of Preoperative Radiation Therapy in Urothelial Carcinoma