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CANCER THERAPY

Biomarkers for neoadjuvant checkpoint blockade response in urothelial cancer

Nature Medicine volume 25, pages 1650–1651 (2019)Cite this article

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Activated CD8+ T cells in the tumor and cytotoxic T cell signature correlate with immune response in patients receiving neoadjuvant immunotherapy for treatment of muscle invasive bladder cancer.

Among the 88 assessable patients, the pathologic complete response (pCR)—the primary endpoint of the study—was 31%. This is comparable to the pCR rate in the PURE-01 trial investigating neoadjuvant treatment of urothelial carcinoma with pembrolizumab6 and neoadjuvant chemoimmunotherapy with gemcitabine/cisplatin and pembrolizumab7. The ABACUS trial included higher-risk patients than in PURE- 01 (pre-operative pembrolizumab) as they were ineligible for treatment with cisplatin and had residual disease in the bladder prior to receiving atezolizumab. It is notable that in the ABACUS trial, patient response was achieved after just two cycles of neoadjuvant immunotherapy, and this is consistent with the neoadjuvant PD-1 blockade in melanoma, in which rapid immune and clinical responses were noted with T cell reinvigoration peaking 1 week after treatment initiation8.

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Fig. 1: Immune biomarkers suggestive of response to neoadjuvant immunotherapy.

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Authors and Affiliations

  1. Fox Chase Cancer Center, Philadelphia, PA, USA

    Pooja Ghatalia & Elizabeth Plimack

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  1. Pooja Ghatalia
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  2. Elizabeth Plimack
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Correspondence to Elizabeth Plimack.

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The authors declare no competing interests.

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Ghatalia, P., Plimack, E. Biomarkers for neoadjuvant checkpoint blockade response in urothelial cancer. Nat Med 25, 1650–1651 (2019). https://doi.org/10.1038/s41591-019-0645-6

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