Immunotherapy and Chemotherapy Use in Patients with Metastatic Bladder Cancer

In this conversation, Ronac Mamtani and Ravi Parikh join Alicia Morgans to discuss their recent work on bladder cancer outcomes and effectiveness research.   They discuss immune checkpoint therapy versus carboplatin chemotherapy in patients with metastatic urothelial cancer (mUC). 

They also discuss the "Association Between FDA Label Restriction and Immunotherapy and Chemotherapy Use in Bladder Cancer" evaluating trends in immunotherapy prescribing, before and after the FDA label-change on June 19, 2018.  The FDA announced it was limiting the use of atezolizumab and pembrolizumab for patients with locally advanced or metastatic urothelial cancer who are not eligible for cisplatin-containing therapy.

The Agency took this action due to decreased survival associated with the use of pembrolizumab or atezolizumab as single therapy (monotherapy) compared to platinum-based chemotherapy in clinical trials to treat patients with metastatic urothelial cancer who have not received prior therapy and who have low expression of the protein programmed death ligand 1 (PD-L1).