Englander Institute for Precision Medicine

Immunotherapy in the Treatment of Localized Genitourinary Cancers.

TitleImmunotherapy in the Treatment of Localized Genitourinary Cancers.
Publication TypeJournal Article
Year of Publication2023
AuthorsNecchi A, Faltas BM, Slovin SF, Meeks JJ, Pal SK, Schwartz LH, Huang RSP, Li R, Manley B, Chahoud J, Ross JS, Spiess PE
JournalJAMA Oncol
Date Published2023 Oct 01
KeywordsCarcinoma, Transitional Cell, Humans, Immunotherapy, Neoplasm Invasiveness, Neoplasm Recurrence, Local, Nivolumab, Progression-Free Survival, Urinary Bladder Neoplasms

IMPORTANCE: A true revolution in the management of advanced genitourinary cancers has occurred with the discovery and adoption of immunotherapy (IO). The therapeutic benefits of IO were recently observed not to be solely confined to patients with disseminated disease but also in select patients with localized and locally advanced genitourinary neoplasms.

OBSERVATIONS: KEYNOTE-057 demonstrated the benefit of pembrolizumab monotherapy for treating high-risk nonmuscle invasive bladder cancer unresponsive to bacillus Calmette-Guérin (BCG), resulting in recent US Food and Drug Administration approval. Furthermore, a current phase 3 trial (Checkmate274) demonstrated a disease-free survival benefit with the administration of adjuvant nivolumab vs placebo in muscle-invasive urothelial carcinoma after radical cystectomy. In addition, the recent highly publicized phase 3 KEYNOTE 564 trial demonstrated a recurrence-free survival benefit of adjuvant pembrolizumab in patients with high-risk localized/locally advanced kidney cancer.

CONCLUSIONS AND RELEVANCE: The adoption and integration of IO in the management of localized genitourinary cancers exhibiting aggressive phenotypes are becoming an emerging therapeutic paradigm. Clinical oncologists and scientists should become familiar with these trials and indications because they are likely to dramatically change our treatment strategies in the months and years to come.

Alternate JournalJAMA Oncol
PubMed ID37561425
Grant ListI01 BX003692 / BX / BLRD VA / United States
I01 BX005599 / BX / BLRD VA / United States

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