GU Cancers 2022 | A real-world study of tumor mutational burden as a predictive biomarker in urothelial carcinoma

Shilpa Gupta, MD, University of Minnesota, Minneapolis, MN, discusses a real-world study assessing the utility of tumor mutational burden as a predictive biomarker for patients with urothelial carcinoma, who are ineligible for cisplatin chemotherapy. The outcomes with standard chemotherapy were compared with the outcomes with pembrolizumab or atezolizumab, two immune checkpoint inhibitors (ICIs). Patients with a tumor mutational burden (TMB) of 10 or higher, achieved better progression-free survival (PFS), overall survival (OS), and time to next treatment with the ICIs than patients with a TMB of less than 10. Patients with a higher TMB achieved better results on ICIs than on chemotherapy, whereas patients with a lower TMB achieved better results on chemotherapy than ICIs. The results of this study support the findings of the DANUBE and IMvigor130 trials, and suggest that TMB is a good biomarker in this setting. This interview took place at the American Society of Clinical Oncology (ASCO) Genitourinary Cancers Symposium 2022 in San Francisco, CA.