Dr. Galsky Discusses Neoadjuvant Immunotherapy in Bladder Cancer

Matthew Galsky, MD, professor of medicine, hematology, and medical oncology, Mount Sinai Hospital, discusses neoadjuvant immunotherapy in bladder cancer.

Immunotherapy, specifically checkpoint inhibitors, have exploded onto the scene of bladder cancer in the last few years. Galsky says that there may be a role for immunotherapy in the neoadjuvant setting of muscle-invasive bladder cancer (MIBC). There are currently multiple single-arm trials assessing immune checkpoint blockade in the neoadjuvant setting for these patients. Historically, chemotherapy has been the standard neoadjuvant therapy followed by cystectomy in patients with cisplatin-eligible MIBC. For patients with MIBC who are not eligible for cisplatin, there is currently no standard preoperative therapy, and these patients are treated with surgery alone, Galsky says.

Although the only studies ongoing are proof-of-concept studies, Galsky says they are intriguing, and will inform further studies that may have the potential to transform care. Current studies are utilizing pathologic complete response rate as the primary endpoint.