Next-Generation Immunotherapy Agents Under Study for Early-Stage Bladder Cancer

Oncology - January 2016

 Christopher Hoimes, MD

The new class of drugs known as immune checkpoint inhibitors, which target molecules that serve as checks and balances in the regulation of immune responses, are proving effective against advanced bladder cancer. UH Seidman Cancer Center genitourinary oncologist and Assistant Professor of Medicine at Case Western Reserve University School of Medicine, Christopher Hoimes, DO, is leading a national trial to discover whether these new therapies can create cures earlier in the disease.

 “If we can boost the number of patients who are cured using these checkpoint inhibitors in stages I through III, that will benefit tens of thousands of patients per year,” Dr. Hoimes says.

Dr. Hoimes has been an investigator on the trials of the investigational immunotherapy drug atezolizumab in patients with advanced or metastatic bladder cancer. Atezolizumab received “Breakthrough Therapy” designation from the U.S. Food and Drug Administration (FDA) for bladder cancer in June 2014. Early results of the trial presented in September 2015 showed that the medication shrank tumors in 27 percent of people with advanced or metastatic urothelial carcinoma whose disease expressed medium and high levels of programmed death ligand-1 (PD-L1).

Dr. Hoimes says the good news about bladder cancer immunotherapy is likely to continue.

“Trials that will be presented and published next year will add to the current data that these precise immunotherapies can impact bladder cancer when it is metastatic and stage IV,” he says.

To bring bladder cancer immunotherapy to a larger patient population, Dr. Hoimes is also leading a national trial he initiated, focusing on using PD-1 and PD-L1 inhibitors earlier in the disease process.

“To really move this field forward, to get deep, long-term remissions in bladder cancer, the idea is to use the immunotherapy medicines sooner in the disease, at stage II and stage III,” he says. “That’s where the opportunity lies.”

As part of the trial, conducted through the Case Comprehensive Cancer Center at Case Western Reserve University and the Hoosier Cancer Research Network, he’ll be collecting bladder tumor samples before, during and after therapy.

“This will help us better understand the host immune system and its anti-cancer defense mechanisms,” Dr. Hoimes says. “We need to understand how the immune system is responding to the tumor at the outset, as well as how it is tuned for an anti-cancer response while on therapy.”

For more information on this immunotherapy trial for early-stage bladder cancer at UH Seidman Cancer Center or to refer a patient, email Christopher.Hoimes@UHhospitals.org.

All National Institutes of Health (NIH) funding for basic and clinical research is awarded to the School of Medicine at Case Western Reserve University.