By Free Republic | Created at 2024-09-23 03:31:39 | Updated at 2024-09-30 11:31:30
1 week ago
New combination treatment brings hope to patients with advanced bladder cancer (2X)
Medical Xpress / University of Chicago Medical Center / JAMA Oncology ^ | Sept. 19, 2024 | Randy F. Sweis et al
Posted on 09/22/2024 8:09:36 PM PDT by ConservativeMind
Findings from the international FORT-2 clinical trial showed a combination treatment including immunotherapy is safe and tolerable in patients with locally advanced or metastatic bladder cancer.
In urothelial bladder cancer, increased T cell infiltration has been correlated with longer patient survival.
In many cases, fibroblast growth factor receptor (FGFR) mutations are known to be drivers of bladder cancer development and progression.
"In 2016, we published studies showing that the tumors with FGFR3 mutations have no T cell infiltration, which led to the logical conclusion that blocking the FGFR pathway could make more patients responsive to immunotherapy," said Sweis.
Previous clinical studies with an FGFR inhibitor, rogaratinib, demonstrated that the treatment is tolerable and could shrink tumors in patients. In pre-clinical cancer models, the combination of FGFR inhibitor and a programmed cell death ligand 1 (PD-L1) inhibitor showed increased survival and antitumor activity.
FORT-2 is a phase 1b/2 non-randomized clinical trial. It is the first clinical trial to evaluate the safety, tolerability and the recommended phase 2 dose of FGFR inhibitor plus PD-L1 inhibitor in advanced urothelial cancer patients with FGFR mRNA high expression.
"By measuring FGFR mRNA gene expression, we found that half of the patients' tumors have activation of the FGFR pathway, whereas previous studies reported only about 15% using a method that measured only FGFR DNA mutations, suggesting overexpression of FGFR captures all mutations and additional tumors where this pathway is relevant," said Sweis.
In previous studies, the response rate reported was 23% with PD-L1 inhibitor, atezolizumab alone and 21% with rogaratinib alone; however, by combining the FGFR inhibitor and PD-L1 inhibitor, the response rate increased to 54%. In addition, the responses were achieved quickly, with a median time to response of 2.1 months, and included many durable responses lasting longer than 2 years.
(Excerpt) Read more at medicalxpress.com ...
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Immunotherapy alone never helped more than 25% of patients. With the extra drug, they help increase the response rate to 54%, with many durable responses lasting beyond two years, so far.
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2 posted on 09/22/2024 8:10:07 PM PDT by ConservativeMind (Trump: Befuddling Democrats, Republicans, and the Media for the benefit of the US and all mankind.)
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