Dr. Gupta on Challenges of Identifying Biomarkers in Bladder Cancer

Shilpa Gupta, MD, staff member, Department of Solid Tumor Oncology, Cleveland Clinic Taussig Cancer Institute, discusses the challenges of identifying predictive biomarkers in bladder cancer.

The introduction of immunotherapy has changed the paradigm of bladder cancer which had limited treatment options in the past. However, only approximately 20% to 25% of patients respond to immunotherapy, says Gupta.

According to Gupta, it is important to investigate which patients will benefit from immunotherapy and which will not. By identifying biomarkers of response, patients who are not likely to derive benefit from immunotherapy could be treated with an alternative strategy upfront rather than being subjected to potential disease progression and financial burden.

To accomplish that, biomarkers have to be better understood in bladder cancer, says Gupta. PD-L1 status appears to be ineffective alone and tumor mutational burden has not shown robust clinical utility yet. Multiple biomarkers may need to be explored concurrently to understand factors that predict for response to immunotherapy in individual patients, concludes Gupta.