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Why test?

Key points

  • Despite advances in treatment, there remains a significant unmet need in patients with advanced or metastatic bladder cancer.
  • Anti-PD-1/PD-L1 immunotherapy is an important treatment choice for these patients.
  • Higher ORRs have been observed in patients with high PD-L1 expression versus those with low/negative PD-L1 expression.
  • Staining tumour samples for PD-L1 expression can inform treatment decisions.

Unmet need in bladder cancer

  • Bladder cancer is the ninth most common cancer worldwide, with ~430,000 new cases diagnosed in 2012.1
  • Despite advances in treatment, the prognosis for patients with bladder cancer, and in particular advanced or metastatic disease, remains poor.2–4

Anti-PD-1/PD-L1 immunotherapy is an important treatment choice in bladder cancer

  • The PD-1/PD-L1 pathway is an important checkpoint used by tumour cells to inhibit antitumour responses.5
  • Levels of tumour PD-L1 expression in UC correlate with disease severity and outcomes.5

Anti-PD-1/PD-L1 immunotherapy has been associated with antitumour activity in bladder cancer

  • Blockade of the PD-1/PD-L1 pathway with anti-PD-1/PD-L1 immunotherapy has been associated with antitumour activity and clinical benefit in patients with UC.5–11
  • Higher ORRs have been observed in patients with tumours characterised by high PD-L1 expression compared with tumours characterised by low PD-L1 expression.6–8,10,11

PD-L1 testing can inform treatment decisions

  • Determining tumour PD-L1 expression status in UC tumours can help inform physicians and patients about the likelihood of response to immunotherapy with anti-PD-1/PD-L1 agents.5

REFERENCES

  1. Antoni S, et al. Eur Urol 2017;71:96–108
  2. Wang SC, et al. Sci Rep 2017;7:4360
  3. National Cancer Institute. SEER stat fact sheets. Bladder cancer. Available at:
    https://seer.cancer.gov/statfacts/html/urinb.html (accessed July 2018)
  4. Witjes A, et al. Eur Urol 2017;71:462–75
  5. Bellmunt J, et al. Cancer Treat Rev 2017;54:58–67
  6. Rosenberg JE, et al. Lancet 2016;387:1909–20
  7. Powles T, et al. JAMA Oncol 2017;3:e172411
  8. Patel MR, et al. Lancet Oncol 2018;19:51–64
  9. Balar AV, et al. Lancet Oncol 2017;389:67–76
  10. Balar A, et al. Lancet 2017;18:1483–92
  11. Sharma P, et al. Lancet Oncol 2017;18:312–22

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