RE:RE:Bladder Cancer Treatment Enters 'Post-Checkpoint' EraClaridge wrote:
Choosing Post-Immunotherapy
Milowsky noted that if these agents become available for use in clinical practice, there will likely be a lack of phase III data accompanying them. "So how do we make decisions about which of these drugs to use?" he said. "We do it in the way that we do it now, we try to pick the right drug for the right patient or the right patient for the right drug."
He suggested checking for biomarkers (14% of bladder cancer patients harbor an FGFR3 mutation, which could make erdafitinib an option), considering pharmacokinetic data, and also looking at the agents' differing toxicity profiles -- "We do this all the day long when we see patients in the clinic even with conventional chemotherapy," he said.
Regarding toxicity, he noted that a patient with significant peripheral neuropathy related to prior platinum-based chemotherapy, underlying diabetes, or other reasons, may not be best selected for a drug enfortumab vedotin, which had some degree of neuropathy in the trial. And for sacituzumab govitecan he noted the risk of myelosuppression and febrile neutropenia as AEs to consider when selecting patients.
I read this research of Claridge , always interesting , and what comes out for me is " we try to pick the right drug " . It sounds like uncertainty not like our precision and destruction PDT\PDC treatment . What would you choose as a cancer patient , localized blasting of cancer cells with no side effects or uncertainty . Commercialization here we come.....
GLTA