With recent FDA approvals of immunotherapy drugs for kidney and bladder cancer, patients now have more options to consider among their treatments. The 2016 ASCO annual meeting featured several new developments in these two cancers that seem to keep the momentum moving forward in this field. We asked Charles Drake, M.D., Ph.D., associate director of the Bloomberg-Kimmel Institute for Immunotherapy at Johns Hopkins, to discuss the significance of the findings.

Following the recent FDA approval of an immunotherapy drug called atezolizumab, which targets a molecule called PD-L1, for second-line treatment of advanced bladder cancer, scientists revealed data from another clinical trial of the drug: Results from a phase II study investigating the PD-L1 inhibitor atezolizumab as first-line therapy for patients with advanced bladder cancer who cannot safely undergo standard therapy (Abstract LBA4500).  In the trial, atezolizumab was given to bladder patients who were not healthy enough to receive conventional high-dose chemotherapy. So, the patients in the trial were given atezolizumab as a so-called first-line therapy. He said, “The response rate in these patients was actually quite good – in the range of about 25 percent.” It’s important, he says, because it gives a good option for these patients. In addition, he says immunologists have long questioned whether checkpoint blockade drugs would work as a first-line treatment as effectively as second or third-line treatments. Moving forward, he says the findings are important for providing bladder cancer patients who are medically ineligible for conventional chemotherapy a new treatment option with a good response rate. With additional clinical trials, Drake’s hope is that scientists will find a “chemo-free” regimen for bladder cancer patients. David McConkey, Ph.D., director of the Johns Hopkins Greenberg Bladder Cancer Institute, also commented on the FDA's approval of "atezo" for second-line treatment of bladder cancer. Watch Drake's video commentary.

Also at #ASCO16, kidney cancer experts will be presenting long-term follow up data on the effectiveness of the immunotherapy drug nivolumab as second-line treatment for kidney cancer patients. Long-term overall survival (OS) with nivolumab in previously treated patients with advanced renal cell carcinoma (aRCC) from phase I and II studies.

Drake, a co-author on the study, says that the data shows favorable outcomes for these patients, specifically that there is a one in three chance that a patient taking this drug in the second line of treatment will be alive 2, 3 and 4 years from now. The scientists also looked at the rate of adverse events over time and whether patients develop long term, autoimmunity-related side effects (which includes arthritis, colitis or pneumonitis). Drake says that the findings are encouraging that there was no indication of long-term autoimmunity-related side effects. He says most of the side effects occur within the first three to six months. Watch Drake's video commentary.

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