Andrea Necchi: Our next piece of the neoadjuvant puzzle in muscle-invasive bladder cancer

Andrea Necchi, Associate Editor at Journal of Clinical Oncology, shared a post on X about a recent paper by Chiara Mercinelli et al. published in JCO.

“First Results of NURE-Combo: A Phase II Study of Neoadjuvant Nivolumab and Nab-Paclitaxel, Followed by Postsurgical Adjuvant Nivolumab, for Muscle-Invasive Bladder Cancer”

Authors: Chiara Mercinelli, Marco Moschini, Antonio Cigliola, Matteo Bellone, Andrea Necchi et al.

“Out in Journal of Clinical Oncology our next piece of the neoadjuvant puzzle in muscle-invasive bladder cancer.

Taxanes could be another good choice of backbone chemo to combine with IO, overcoming the known limits of platinum.
Nure Combo provided Nivo/ABX x4 > RC > adj Nivo x13. N=31.

22 pts (70.9%, 95%CI: 51.9-85.8%) achieved a ypT</=1N0-x response.

In the ITT population, 10 pts (32.3%, 95% CI: 16.7-51.4) achieved an ypT0N0 response. By including those who underwent reTURBT, 12 pts (38.7%; 95%CI: 22-56) achieved an ypT0N0-x response.

12m-EFS in ITT population was 89.8%.

Grade 3 TRAEs occurred in 8 pts (25.8%) and Grade 3 irAE occurred in 4 patients (12.9%). No Grade 4-5 TRAEs were observed.

Patients with an ypT0N0 response had lower baseline fraction of PMN cells (CD15+CD45+) compared to ypT</=1N0 responders and nonresponders (ypT≥2N0 and ypN+).

Longitudinal analyses showed that at C2D1 the fraction of CD11b+CD33+CD14+HLA-DRlow/int monocytic myeloid cells increased in both complete responders and partial/non-responders.

These values tended to normalize to baseline values pre-RC. Similar findings for CD14+CD16+ intermediate monocytes. These data suggest that neoadjuvant nivo/abx modulated myeloid immune response in the peripheral blood.

Finally, educational and growing career path of neoadjuvant platform continued. Commitment of pts and families, first author resident Chiara Mercinelli. And the outstanding team made this idea possible.

A special thank to AIRC – The Italian Foundation for Cancer Research for granting support for the body of biomarker analyses and scientists from Foundation Medicine, Jeff Ross, Dean Pavlick for their vision and efforts.”

Source: Andrea Necchi/X

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