ESMO 2019 — Bladder cancer: immunotherapy on top of chemotherapy brings first improvement in decades


  • Michael Simm
  • Oncology Conference reports
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • Progression free survival (PFS) in previously untreated patients with metastatic urothelial cancer is increased significantly by adding the PD-L1 inhibitor atezolizumab to platinum-based chemotherapy.
  • The improvement in PFS was moderate, and overall survival did not cross the prespecified interim efficacy boundary.

Why this matters

  • There have been no big improvements in metastasized urothelial cancer since the 1980s.
  • This is the largest trial in this indication.

Study design

  • IMvigor130 is a phase 3 trial with 1213 patients with metastatic urothelial cancer from 35 countries.
  • Randomisation to atezolizumab plus platinum-based chemotherapy (Arm A), atezolizumab (Arm B) or placebo plus platinum-based chemotherapy (Arm C).
  • Funding: F. Hoffmann-La Roche, Ltd.

Key results

  • After a median follow-up of 11.8 months, median PFS was 8.2 months in Arm A and 6.3 months in Arm C (HR 0.82; 95% CI 0.70-0.96; P=0.007).
  • Median overall survival was 16.0 vs 13.4 months in Arms A and C, respectively (HR 0.83: 95% CI 0.69-1.00; P=0.027).
  • Complete response rates were 13%, 6% and 7% in Arms A, B, and C, respectively.
  • Withdrawal due to adverse events was 34%, 6%, and 34% in Arms A, B, and C respectively.

Limitations

  • Interim analysis with short follow-up.
  • No data on quality of life.