Arlene Siefker-Radtke, MD, University of Texas MD Anderson Cancer Center, Houston, TX, discusses the pros and cons of immunotherapy (IO) versus cystectomy in urothelial carcinoma. IO plays a significant role in both the metastatic and early stage disease in the adjuvant setting following bladder removal. The question is whether IO could provide benefit in the first-line setting prior to cystectomy. Early data suggests pathologic complete response rates with first-line IO similar to what has been observed with cisplatin-based chemotherapy, however, larger clinical trials will be essential to confirm this benefit. Additional data has indicated positive response rates with the use of antibody drug conjugates (ADCs) combined with IO, such as enfortumab vedotin plus pembrolizumab. This interview took place at the ASCO GU Cancers Symposium 2023 in San Francisco, CA.
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