Letter to Editor
Precision Immuno-Oncology: How Can we Improve Responses to Immunotherapy in Bladder Cancer?
Kris Prado and Chin Arnold*
Department of Urology, Broad Stem Cell Research Center, and Jonsson Comprehensive Cancer Center, USA
*Corresponding author: Chin Arnold, Department of Urology, Broad Stem Cell Research Center, and Jonsson Comprehensive Cancer Center, USA
Published: 12 Oct, 2017
Cite this article as: Prado K, Arnold C. Precision Immuno-
Oncology: How Can we Improve
Responses to Immunotherapy in
Bladder Cancer?. Clin Oncol. 2017; 2:
1355.
Letter to Editor
Immuno-Oncology has energized the oncology landscape, including in the treatment of bladder cancer. Validation of multiple combinational strategies and novel immune targets will be forthcoming. Current challenges in PD-1/PD-L1 checkpoint inhibition have been developing accurate biomarkers to predict response, as PD-L1 expression itself is an inaccurate indicator. Mutational load or burden is indicative of tumor immunogenicity and thus susceptibility to immunotherapy. Perhaps these parameters will be more predictive than PD-L1 expression. I Vigor 210 revealed higher response and survival rates to atezolizumabin patients with increased mutational burdens [1]. Furthermore, mismatch repair mechanisms can influence mutational load and mutation-associated neo-antigens, with evidence that patients with mismatch repair deficiencies are more sensitive to anti-PD-1 therapy across multiple cancer types [2]. Fundamental understanding and clinical evaluation of mismatch repair deficiency and mutational load will be imperative in moving forward with immunotherapy for muscle invasive bladder cancer.
References
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- Le DT, Durham JN, Smith KN, Wang H, Bartlett BR, Aulakh LK, et al. Mismatch-repair deficiency predicts response of solid tumors to PD-1 blockade. Science. 2017;357(6349):409-413.