Dr. Grivas Highlights Three Practice-Changing Trials in Bladder Cancer

There have been three recent, practice-changing, phase 3 trials clinical trials to note for patients with bladder cancer, according to Dr. Petros Grivas, a professor in the Division of Hematology and Oncology, at the University of Washington School of Medicine, in Seattle.

In an interview with CURE, Grivas highlighted these trials of interest for patients, emphasizing the importance of tailoring treatment decisions in advanced bladder cancer based on data from JAVELIN Bladder 100, CheckMate 901 and EV-302. It is also important to consider drug availability, patient eligibility, comorbidities and individual preferences to provide the most effective and personalized care, according to him.

Grivas also serves as the clinical director of the Genitourinary Cancers Program and a professor in the Clinical Research Division at Fred Hutch Cancer Center.

Transcript:

We have three practice-changing phase 3 trials: the JAVELIN Bladder 100 trial with switch maintenance Bavencio in patients with no progression after prior platinum-based chemotherapy; the CheckMate 901 trial, where gemcitabine plus cisplatin plus Opdivo (nivolumab) was better than gemcitabine plus cisplatin in cisplatin-eligible patients; and the EV-302/KEYNOTE-A39 trial, with Keytruda (pembrolizumab) plus Padcev(enfortumab vedotin-ejfv), showing dramatic improvement in progression-free and overall survival compared with platinum-based chemotherapy.

Overall, Keytruda plus Padcev, based on the EV-302 trial, is the preferred standard of care. However, in many countries, this regimen or combination is not available due to lack of access or reimbursement. I think that's important to note because there are disparities in healthcare across different countries. Especially in countries where this Keytruda combination is not available, we have to consider even more the data from the JAVELIN Bladder 100 trial with switch maintenance Bavencio, particularly for patients who are cisplatin-ineligible and cannot receive cisplatin; the gemcitabine plus cisplatin plus Opdivo data do not apply to them.

The JAVELIN Bladder 100 trial remains the standard of care in countries where Keytruda plus Padcev is not available for cisplatin-ineligible patients. I think it's important to keep these three practice-changing trials in mind. We have to make the best individualized, personalized decision in clinical practice. We discuss the data with our patients. We take into account medical comorbidities, performance status, and organ function. We want to ensure we consider those relevant clinical factors when we make informed and shared decisions with our patients.

It's also important to hear our patients' priorities, wishes and treatment expectations, to consider efficacy data, toxicity data, quality of life and patient-reported outcomes data. To make informed decisions with our patients, we want to use the best treatment we have upfront. At the same time, we have to consider the particular details and specific context for individual patients.

Transcript has been edited for clarity and conciseness.

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