Matthew D. Galsky, MD, on How Data in Neoadjuvant Therapy May Inform Future Research Across Tumor Types

CancerNetwork® spoke with Matthew D. Galsky, MD, during the American Association for Cancer Research Annual Meeting 2021 to discuss leading data to come out of the meeting and what it means for the future of cancer systemic therapy.

CancerNetwork® sat down with Matthew D. Galsky, MD, to discuss some of the data to come out of the American Association for Cancer Research (AACR) Annual Meeting 2021 that offer the greatest promise to the cancer treatment paradigm going forward. Interestingly, Galsky cited data regarding neoadjuvant therapy in the lung cancer setting as a promising indicator for future research in the genitourinary space.


One of the more interesting findings from a genitourinary oncologist’s standpoint is an observation from a lung cancer study that [looked at] neoadjuvant chemotherapy plus immune checkpoint blockade. [It showed] with the combination of immune checkpoint blockade plus chemotherapy a much higher pathologic complete response rate compared with chemotherapy alone. Again, that reinforces this concept of whether what we’re observing in metastatic urothelial cancer is a function of the chemotherapy backbone or that lung cancer and bladder cancer are just very different diseases, and we won’t see the same thing.

But the reason that the neoadjuvant lung cancer study is important to us in the field is that we have a number of ongoing neoadjuvant studies combining cisplatin-based chemotherapy with PD-1 or PD-L1 blockade for patients with muscle-invasive bladder cancer. If that is a hint of what we might see in bladder cancer as well, where the chemotherapy backbone in the neoadjuvant study is homogeneous and there isn’t this issue of carboplatin, hopefully we’ll see similar results in bladder cancer because we haven’t had new neoadjuvant chemotherapy regimens in this disease in decades.