Gemcitabine, Cisplatin, Nivolumab Facilitate Bladder Sparing

Clinical complete response of 43 percent seen for those with muscle-invasive bladder cancer receiving neoadjuvant gemcitabine, cisplatin, plus nivolumab

By Elana Gotkine HealthDay Reporter

WEDNESDAY, Oct. 4, 2023 (HealthDay News) — For patients with muscle-invasive bladder cancer (MIBC), treatment with gemcitabine, cisplatin, plus nivolumab facilitates bladder sparing, according to a study published online Oct. 2 in Nature Medicine.

Matthew D. Galsky, M.D., from the Icahn School of Medicine at Mount Sinai in New York City, and colleagues conducted a phase 2 study of 76 patients with MIBC who received four cycles of gemcitabine, cisplatin, plus nivolumab followed by clinical restaging. Patients who achieved a clinical complete response (cCR) could proceed without cystectomy.

Of the patients, 33 achieved a cCR (43 percent); 32 of the 33 opted to forgo immediate cystectomy. The researchers found that the positive predictive value of cCR for a composite outcome of two-year metastasis-free survival in patients forgoing immediate cystectomy or ATM, RB1, FANCC, and ERCC2) or increased tumor mutational burden. There was an association noted between the baseline and on-treatment immune contexture with clinical outcomes.

“Treatment for muscle-invasive bladder cancer is in need of major improvements from both a quality-of-life and an effectiveness standpoint,” Galsky said in a statement. “If additional research confirms our findings, this may lead to a new paradigm in the treatment of muscle-invasive bladder cancer.”

Several authors disclosed ties to the biopharmaceutical and medical technology industries.

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