Dr. Petrylak on Sequencing of Targeted Agents in Bladder Cancer

Daniel P. Petrylak, MD, professor of Medicine and Urology, Yale Cancer Center, discusses major targeted agents currently being studied in the treatment of patients with bladder cancer.

Petrylak is currently leading a trial with the AGS-15E antibody, which targets what is called SLITRK4, a neuroendocrine marker on bladder cancer cells. This antibody is linked to a chemotherapeutic agent, MME, which is an antitubulin agent. Moreover, he says Dr. Jonathan Rosenberg is working with an antinectin antibody called the 22CE antibody.

Thus far, the data on targeted agents in this space have shown a 50% overall response rate in patients who failed previous therapy. Petrylak breaks the data down further, explaining that there is an approximate 30% response rate in liver, and about a 35% to 40% response rate for patients who failed prior checkpoint inhibition therapy. Some preclinical studies now suggest that there may be synergy between these targeted antibody-drug conjugates and checkpoint inhibition.

According to Petrylak, another trial is currently looking at ramucirumab (Cyramza) in combination with docetaxel, compared with docetaxel alone in patients who failed prior first-line chemotherapy and also those who have been treated with prior checkpoint therapy. Overall, he anticipates that future data will show interesting sequencing and outcomes associated with these particular agents.