Atezolizumab is currently in clinical development for the treatment of patients muscle-invasive urothelial cancer (MIUC) including muscle-invasive bladder cancer (MIBC) and upper tract urothelial cancer (UTUC) patients who are at high risk following resection. MIBC is a cancer that spreads into the thick muscle deep in the bladder wall. MIBC starts in the inner bladder layer and then grows in the deep muscle. While UTUC can arise along any part of the urinary tract lined with urothelium with the majority of cases in the lower tract and rest in the upper tract. Over time the tumour may grow outside the bladder into tissues close by and then may spread to lymph nodes, the lungs, the liver and other parts of the body. The current standard care of treatment includes a surgery which might not be adequate and some patients might be at high risk for recurrence.
Atezolizumab is a cancer medicine that is designed to recognise and attach to a protein called PD-L1, which is present in many cells. By attaching to PD-L1 and reducing its effects, atezolizumab increases the ability of the immune system to attack the cancer cells and thereby slow down progression of the disease. If licensed, atezolizumab will offer an adjuvant treatment for muscle-invasive urothelial carcinoma (MIUC) patients who are at high-risk for recurrence following resection.
Durvalumab is in development for patients with advanced/metastatic non-small cell lung cancer (NSCLC) who are EGFR/ALK wild-type and whose tumours have a high PD-L1 expression. NSCLC makes up the majority of lung cancers in the UK. Advanced/metastatic (Stage IV) NSCLC is when the cancer has spread beyond the lung which was initially affected, most often to the liver, the adrenal glands, the bones and the brain. Most patients with NSCLC are diagnosed at the advanced/metastatic stage where curative treatment with surgery is unsuitable. Currently, chemotherapy remains the first line treatment option but this is often not well tolerated by many patients.