Opdivo (nivolumab) is an immune checkpoint inhibitor that binds to PD-1 and contributes to cancer cell death. It has shown efficacy in treating a number of cancer types, both as a monotherapy and in combination with other treatments; these types include hepatocellular carcinoma (HCC), Hodgkin lymphoma, malignant pleural mesothelioma (MPM), melanoma, and stomach cancer, among others. An article in CURE shared that a substudy of the Phase 3 CheckMate-901 clinical study explored how well Opdivo worked in treating unresectable or metastatic urothelial carcinoma when used alongside cisplatin-based chemotherapy.
608 participants enrolled in this substudy. To enroll, participants must have urothelial carcinoma that was unresectable (not surgically removable), untreated, or metastatic (spread to other areas of the body). It’s important to evaluate new therapies for this group. An estimated 20-25% of people have their cancer metastasize; nearly 50% of those who have surgery experience urothelial carcinoma progression or recurrence at a later date. Thus, there is a huge unmet need and identifying effective treatments could significantly benefit these individuals.
During the study, participants received either chemotherapy as a monotherapy, or chemotherapy as well as 360mg Opdivo and Yervoy (ipilimumab). Preliminary data highlights the benefits of adding Opdivo to the treatment plan. First, Opdivo was safe and well-tolerated when used in conjunction with chemotherapy. Participants receiving Opdivo as part of their treatment also survived longer and experienced longer periods of progression-free survival (living without the cancer getting worse).
The larger CheckMate-901 study is still ongoing. However, these initial findings do suggest that this could largely benefit the patient population.
Understanding Urothelial Carcinoma
Also known as: Bladder cancer; transitional cell carcinoma
Urothelial carcinoma accounts for approximately 90% of bladder cancer diagnoses (and 7-10% of kidney cancer diagnoses). This cancer manifests in urothelial cells which line the bladder and other areas along the urinary tract. As the cells become mutated, a tumor forms. Doctors still don’t know the exact cause of urothelial carcinoma. But they have identified certain risk factors. Being male, Caucasian, older than 55, and a smoker all increase the risk, as do smoking cigarettes, certain medications, and chronic bladder infections. Symptoms can (but do not always) include:
- Hematuria (blood in the urine)
- Changes in bladder habits, such as urinating more or less frequently or not being able to urinate
- Unintended weight loss
- Swollen feet
- Low-grade fever
- A lump or mass in the kidney area
- Appetite loss
- Painful urination
- Fatigue and general malaise
- Bone pain
- Unilateral (one-sided) lower back pain
Right now, doctors will decide how to treat patients based on a number of factors, including the cancer’s stage and the patient’s health. Immunotherapy, targeted therapy, radiation, chemotherapy, surgery, or intravesical therapy may all be utilized.