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GU Symposium 2021: Neoadjuvant Durvalumab Plus Chemotherapy in Muscle-Invasive Urothelial Carcinoma

By: Joseph Cupolo
Posted: Thursday, March 4, 2021

The first results from the phase II SAKK 06/17 study revealed that neoadjuvant durvalumab in combination with cisplatin and gemcitabine for operable muscle-invasive urothelial cancer confirmed elevated pathologic response rates and demonstrated acceptable safety, according to Richard Cathomas, MD, of Kantonsspital, Graubünden, Switzerland. He presented these findings on behalf of his colleagues during the virtual edition of the 2021 Genitourinary (GU) Cancers Symposium (Abstract 430). The estimated study completion date is April 2026.

In total, 58 patients with either bladder cancer (95%) or upper urinary tract/urethral cancer (5%) participated in the study. Clinical stage T2, T3, and T4 cancers were present at diagnosis in 69%, 21%, and 10% of patients, respectively. As for treatment, 95% of patients received all four doses of neoadjuvant durvalumab, 81% received all four cycles of cisplatin and gemcitabine, and 17% were switched to carboplatin. In total, grade 3 and 4 adverse events during neoadjuvant treatment occurred in 48% and 27% of patients, respectively. As for postoperative complications, 13 patients (24%) had a Clavien-Dindo grade III classification, and 5 patients (9%) had a Clavien-Dindo grade IV classification. The pathologic response rate was 60% in 18 patients.

“Using the combination of durvalumab and cisplatin and gemcitabine in the neoadjuvant setting for patients with muscle-invasive urothelial cancer may improve pathologic response rates but carries the risk of increased perioperative morbidity,” the investigators concluded.

Disclosure: For full disclosures of the study authors, visit coi.asco.org.



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