The Future of Personalized Care in Bladder Cancer

Jeanny B. Aragon-Ching, MD, FACP, Clinical Program Director of Genitourinary Cancers at Inova Schar Cancer Institute, offers her thoughts on whether bladder cancer lends itself to a personalized care approach.

Dr. Aragon-Ching: In metastatic urothelial cancer, truly the only “targeted therapy” we have is FGFR inhibition. So now that’s not to say that there is no role for getting genomic sequencing and testing for all patients because another big topic in urothelial cancer is, well, which sequence do we give these drugs for? So for instance, if you really know that there is FGFR alteration, how do you sequence after, let’s say, failure from, let’s say, upfront chemotherapy, avelumab maintenance? Do you give ADC first or do you give the FGFR inhibitor first?

So those are the key questions, and a lot of folks would say, well, if there is a true target, then perhaps giving a drug that is meant to work for that targetable mutation would make sense rather than a blanket drug that would have an effect regardless of whether you have the mutation or not, but those are things, or those clinical questions are still being further elucidated in several trials, but you’re right. I mean, I think we’re still searching for those right targets. So for instance, HER2 has been present for a long time, and it is only now that people are looking at specific drugs to target HER2, but we would have to see how these clinical trials pan out and whether or not it’s going to change the standard of care as it is right now.

View Dr. Aragon-Ching’s other comments on locally advanced or metastatic urothelial carcinoma, including Maintenance Therapy Options, Disease Progression After Maintenance Therapy, and ASCO-GU Clinical Research of Interest.