For a patient with metastatic urothelial cancer who has progressed on platinum-based chemotherapy, do you test for tumor PD-L1 expression prior to choosing atezolizumab as second-line treatment?
In the IMvigor 210 trial, increased PD-L1 expression in patients’ tumors was associated with response to atezolizumab, but some patients whose tumors were negative for PD-L1 still responded. Do you switch all patients to atezolizumab after progression on platinum, or only those with PD-L1 expression?
Answer from: Medical Oncologist at Academic Institution
Currently, atezolizumab is the only drug FDA approved for treatment of patients with metastsatic urothelial cancer progressive despite first-line platinum based chemotherapy. Prior to the approval of atezolizumab, commonly used agents were taxanes or pemetrexed based on small to moderate sized singl...
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