Durvalumab in urothelial cancers

ABSTRACT

Introduction: Urothelial bladder cancer is one of the most predominant malignancies worldwide with a poor prognosis when presented at an advanced or metastatic stage. Improving the therapeutic landscape in this setting has been an unmet medical need. Palliative cisplatin-based chemotherapy is currently the standard of care in first line therapies, but many patients are ineligible and few alternative therapies exist. Moreover second-line chemotherapy has minimal activity. Recently, immune-checkpoint inhibitors have shifted the therapeutic armamentarium of bladder cancer and it is now necessary to redesign the therapeutic paradigm.

Areas covered: In this article, we focus on the development of durvalumab and provide an overview of the safety, activity, efficacy and future perspectives of this drug in urothelial carcinoma.

Expert commentary: Durvalumab is a well-tolerated drug and demonstrated major and durable response in advanced bladder cancer. Combinations with durvalumab will probably emerge as promising therapeutic strategies for the treatment of urothelial carcinoma. Further research efforts are needed to identify predictive biomarkers of response to immune-oncology agents.

KEYWORDS:

• Immunotherapy
• PD-L1 inhibitor
• durvalumab
• urothelial carcinoma
• bladder cancer

Declaration of interest

C Massard has served on the advisory board and acted as a speaker/investigator for Amgen, Astellas, AstraZeneca, Bayer, Celgen, Genentech, Ipsen, Jansen, Lilly, Novartis, Pfizer, Roche, Sanofi and Orion. Y Loriot has served on the advisory board and delivered lectures for AstraZeneca, Roche, MSD, Astellas, Janssen, Ipsen and Sanofi. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. A reviewer on this manuscript has disclosed that they are on the advisory board for AstraZeneca. Peer reviewers on this manuscript have no other relevant financial or other relationships to disclose.

Additional information

Funding

This manuscript has not been funded.