FDA/CDC

Durvalumab approved for advanced urothelial carcinoma


 

The Food and Drug Administration has granted accelerated approval to the checkpoint inhibitor durvalumab for patients with locally advanced or metastatic urothelial carcinoma who have disease progression after prior treatment with a platinum-containing chemotherapy.

The agency also approved a complementary diagnostic for the assessment of the PD-L1 protein the tumor tissue.

Approval was based on an objective response rate (ORR) of 17% (95% confidence interval, 11.9-23.3) in a single-arm trial of 182 patients with locally advanced or metastatic urothelial carcinoma whose disease progressed following platinum-containing chemotherapy. Durvalumab, 10 mg/kg, was administered intravenously every 2 weeks. The median response duration was not reached at data cutoff (range, 0.9+ months to 19.9+ months). Confirmed ORR was 26.3% (95% CI, 17.8-36.4) in 95 patients with a high PD-L1 score and 4.1% (95% CI, 0.9-11.5) in 73 patients with a low or negative PD-L1 score, according to a statement from the FDA.

The most common adverse reactions were fatigue, musculoskeletal pain, constipation, decreased appetite, nausea, peripheral edema, and urinary tract infection. Pneumonitis, hepatitis, colitis, thyroid disease, adrenal insufficiency, and diabetes also occurred in patients taking durvalumab.

The recommended dose of durvalumab is 10 mg/kg IV over a period of 60 minutes, every 2 weeks, until disease progression or unacceptable toxicity occurs. Full prescribing information is available here.

Durvalumab is marketed as Imfinzi by AstraZeneca. The complementary diagnostic is the Ventana PD-L1 (SP263) Assay from Ventana Medical Systems.

Recommended Reading

Chemo gives no boost to ADT for patients with localized prostate cancer
MDedge Hematology and Oncology
Outcomes of neoadjuvant therapy vary by subtype in bladder cancer
MDedge Hematology and Oncology
No benefit from adjuvant sunitinib or sorafenib for clear cell renal cancer
MDedge Hematology and Oncology
Point of prostate cancer diagnosis experiences and needs of black men: the Florida CaPCaS study
MDedge Hematology and Oncology
Unavoidable, random DNA replication errors are the most common cancer drivers
MDedge Hematology and Oncology
Metformin linked with better survival in RCC patients with diabetes
MDedge Hematology and Oncology
Ultrasound, cystoscopy combo tops CT for asymptomatic microscopic hematuria
MDedge Hematology and Oncology
Paraneoplastic leukemoid reaction – poor prognostic marker in urothelial bladder carcinoma
MDedge Hematology and Oncology
Lenvatinib expands its reach into renal cell carcinoma
MDedge Hematology and Oncology
Liquid gold: blood-based biopsies make headway
MDedge Hematology and Oncology