What Did the Research Discover?
Researchers conducted a phase 3 clinical trial to evaluate whether adding nivolumab, an immune therapy, to the standard chemotherapy drugs gemcitabine and cisplatin would improve survival for patients with advanced urothelial carcinoma (a type of bladder cancer).
The study included 608 patients with unresectable or metastatic urothelial carcinoma who had not received prior treatment. They were randomly divided into two groups:
- One group received nivolumab plus gemcitabine–cisplatin every three weeks for up to six cycles, followed by nivolumab alone every four weeks for up to two years.
- The other group received only gemcitabine–cisplatin every three weeks for up to six cycles.
After a median follow-up of 33.6 months, the results showed that patients who received nivolumab with chemotherapy lived longer than those who received chemotherapy alone:
- Overall survival: The nivolumab group had a median survival of 21.7 months, compared to 18.9 months for the chemotherapy-only group.
- Progression-free survival: The nivolumab group had a 7.9-month median before the cancer worsened, compared to 7.6 months for chemotherapy alone.
- Response rate: More patients responded to treatment in the nivolumab group (57.6%) compared to the chemotherapy-only group (43.1%). The nivolumab group also had a higher complete response rate (21.7% vs. 11.8%).
- Side effects: Serious side effects (Grade 3 or higher) occurred in 61.8% of nivolumab-treated patients and 51.7% of chemotherapy-only patients.
The findings suggest that adding nivolumab to standard chemotherapy significantly improves survival and may provide a better long-term response in patients with advanced bladder cancer.
How Can I Apply This Information?
If you or someone you know has advanced urothelial carcinoma, this study provides hope that nivolumab plus chemotherapy may be a more effective treatment than chemotherapy alone. Since this study was conducted as a clinical trial, the results will help guide doctors in deciding on new treatment options.
However, this treatment is not yet the standard for all patients, and it may not be suitable for everyone. If you are facing treatment decisions for advanced bladder cancer, talk to your doctor about:
- Whether nivolumab plus chemotherapy is an option for you.
- The possible benefits and risks of this combination therapy.
- The side effects and how they may affect your quality of life.
Additionally, if you are interested in accessing new treatments before they become widely available, consider asking your doctor about clinical trials. Clinical trials test promising new treatments, and participating could give you early access to cutting-edge therapies while helping advance cancer research.
Source:
Van Der Heijden MS, Sonpavde G, Powles T, Necchi A, Burotto M, Schenker M, Sade JP, Bamias A, Beuzeboc P, Bedke J, Oldenburg J. Nivolumab plus gemcitabine–cisplatin in advanced urothelial carcinoma. New England Journal of Medicine. 2023 Nov 9;389(19):1778-89. https://pubmed.ncbi.nlm.nih.gov/37870949/
