A Study of Atezolizumab Compared With Chemotherapy in Patients With Locally Advanced or Metastatic Urothelial Bladder Cancer [IMvigor211]

Participating centers: 
United States (several centers), Australia, Austria, Belgium, Canada, Czech Republic, Denmark, Finland, France, Germany, Greece, Hungary, Italy, Japan, Korea, Netherlands, Norway, Poland, Portugal, Romania, Russian Federation, Serbia, Slovenia, Spain, Sweden, Switzerland, Taiwan, Turkey, United Kingdom
expected 767
Study Design: 
Phase III, randomized trial comparing atezolizumab (anti-PD-L1 antibody) with chemotherapy in locally advanced or metastatic urothelial bladder cancer after failure with platinum-containing chemotherapy
Powles et al. reported a 26% overall response rate with atezolizumab in patients with metastatic urothelial cancer in a Phase I study. Recently, more data in heavily pretreated patients from the IMvigor210 study have been presented by Rosenberg et al. at the European Cancer Congress (Vienna, September 2015) meeting and at the Genitourinary Cancers Symposium (GUCS) in January 2016. IMvigor 210 enrolled an all-comer population independent of PD-L1 immunohistochemistry (IC) status (n=311). There was a 27% response rate in patients with IC2/3 status, 10% with IC1 and 9% with IC0. Therefore, the IMvigor211 trial is trying to establish the merits of using atezolizumab in the second-line setting after failing platinum-based chemotherapy.
It will be interesting to see how the responses and more importantly overall survival of second-line chemotherapy will compare with second-line immunotherapy, that has been shown to improve OS in other tumor types.