Immunomodulatory treatment in urothelial cancer
Mené sur 86 patients atteints d'un carcinome urothélial métastatique ou récidivant après une chimiothérapie à base de sels de platine, cet essai de phase I/II évalue l'efficacité, du point de vue du taux de réponse objective, et la toxicité du nivolumab en monothérapie (durée médiane de suivi : 15,2 mois)
The 38-year interval between US Food and Drug Administration (FDA) approval of cisplatin and approval of the antibody against PD-L1, atezolizumab, provides a striking reminder of the therapeutic challenges faced by patients with advanced urothelial cancer and their clinicians. With the exception of a subset of patients with nodal metastatic disease who can be cured with cisplatin-based chemotherapy, urothelial cancer is an aggressive, incurable disease. Progress in this disease has been extremely slow, in part as a result of a poor understanding of the molecular biology of the disease; the complex patient population given the typical age (median 73 years) and the large proportion of patients with substantial comorbidities, including renal insufficiency; and the difficulty in completing phase 3 trials (eg, because of the age of patients, high number of comorbidities, and high proportion of smokers), especially in the USA over the past decade, where use of unapproved second-line chemotherapy drugs has become widespread.
The Lancet Oncology , commentaire, 2015