Dr. Packiam on Safety of Cabazitaxel/Gemcitabine Plus Pembrolizumab in Urothelial Carcinoma

Vignesh Packiam, MD, urologist, assistant professor of Urology, University of Iowa Hospitals and Clinics, discusses the adverse effects (AEs) associated with cabazitaxel and gemcitabine with pembrolizumab (Keytruda) in patients who are unresponsive to docetaxel with non-muscle invasive urothelial carcinoma.

Findings from a retrospective analysis showed 5 patients developed significant bladder toxicity with the regimen, though it may have been a result of their heavy treatment history with alternative therapies, Packiam says. Several patients had to have treatment with gemcitabine and cabazitaxel paused to allow their bladders to recover, Packiam explains. Moreover, 1 patient required a cystectomy due to end-stage bladder symptoms, Packiam adds.

The optimal dosing of cabazitaxel, gemcitabine, and pembrolizumab is still being explored, and the study has transitioned into a prospective protocol, where investigators will evaluate the optimal dosing regimen, Packiam concludes.