Dr. Sonpavde on Remaining Questions With Immunotherapy in Bladder Cancer

Guru Sonpavde, MD, director of Bladder Cancer at Dana-Farber Cancer Institute, discusses remaining questions with immunotherapy in bladder cancer.

PD-1/PD-L1 inhibitors have shown great tolerability among patients with bladder cancer. Only 15% to 20% of patients have experienced grade 3 or 4 toxicities. That is less than what is typically seen with chemotherapy, notes Sonpavde. Responses are seen in 15% to 20% of patients in the post-platinum setting.

There is no doubt that immunotherapy has a great therapeutic index in bladder cancer, says Sonpavde, but questions remain with the therapy. These include patients who have a poor chance of response and those who may progress through the therapy. Additionally, if patients can be identified earlier on, they may be spared of ineffective treatment.

Physicians do not yet have a validated biomarker that can be used to select patients, but there are many clues as to whether patients will respond to immunotherapy, explains Sonpavde, some of which include tumor mutational burden, PD-L1, and gene expression.