- Higher RNA-based immune signature scores showed significant association with complete response in patients with muscle invasive bladder cancer (MIBC) receiving neoadjuvant pembrolizumab, but not after neoadjuvant chemotherapy.
- No significant PFS improvement was observed with either treatment.
Why this matters
- RNA profiling can help identify patients likely to benefit from preoperative immunotherapy.
- Molecular expression was evaluated in participants from the prospective PURE-01 study (n=84; treatment, neoadjuvant pembrolizumab) and a retrospective multicenter cohort (n=140; treatment, neoadjuvant chemotherapy).
- Median follow-up was 18.4 and 8 months, respectively.
- Funding: MSD.
- 4 immune signatures showed a significant association (aORs) with complete response in the PURE-01 study, but not in the retrospective cohort:
- The Immune190: 1.51 (P=.02).
- Interferon alpha: 1.07 (P=.006).
- Interferon gamma: 1.11 (P=.004).
- Inflammatory: 1.23 (P=.01).
- No significant difference in PFS was observed with higher vs lower Immune190 scores in the PURE-01 (P=.15) and retrospective cohorts (P=.10).
- Basal subtypes (across classifications) with higher vs lower Immune190 scores showed superior PFS after pembrolizumab therapy (all P=.04).
- Neuroendocrine-like tumors had the worst 2-year PFS:
- PURE-01: 33%.
- Retrospective cohort: 0%.
- Claudin-low tumors had the best PFS with pembrolizumab vs chemotherapy.
- Short follow-up.