Afternoon Seminar

[AS-02] Basic Mechanisms of Cancer Immunity and Treatment of Metastatic Urothelial Carcinoma

*Se Hoon Park¹ (1. Samsung Medical Center, Sungkyunkwan University)

[Biography]
Dr. Se Hoon Park is a professor at the Medical Oncology department, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. He received his medical degree from Konkuk University College of Medicine. He was named a reseach scientist at the Harvard School of Public Health between 2010 and 2012. He is board-certified in Internal Medicine and Medical Oncology. His research interests include gastric and urological cancers, as well as early-phase clinical trials. He has been an active investigator in clinical trials during the past years. Dr Se Hoon Park has published more than 100 original publications in the scientific literature, co-authored pivotal papers in urological cancers published in NEJM, Lancet, and others.

Recent progress in understanding the immune responses that underlie cancer cell survival offer the prospect of specifically targeting immune systems to achieve more effective and rational cancer therapy. We already have multiple immunotherapeutic agents targeting PD-1/PD-L1 , with level 1 evidence for activity in the treatment of metastatic urothelial carcinoma (mUC). Pembrolizumab targets PD-1, and can be used either alone [1] or in combination with enfortumab vedotin. Another anti-PD-L1 targeting monoclonal antibody avelumab has been approved for patients with mUC who do not progress following first-line platinum-based chemotherapy [2]. The next challenge is to optimize treatment selection and sequencing for individual patients. More importantly, in the absence of reliable biomarkers, it is crucial to monitor the response to treatments so that the patient does not miss a valuable therapeutic window to receive alternative treatment that may prolong life. This review will focus on the use of the immune-modulating strategies in the treatment of mUC. Basic mechanisms of immunotherapy and the problems concerning the choice of specific therapies are discussed.

1. Bellmunt J, de Wit R, Vaughn DJ, Fradet Y, Lee JL, Fong L, et al. Pembrolizumab as Second-Line Therapy for Advanced Urothelial Carcinoma. N Engl J Med. 2017;376:1015-26.

2. Powles T, Park SH, Voog E, Caserta C, Valderrama BP, Gurney H, et al. Avelumab Maintenance Therapy for Advanced or Metastatic Urothelial Carcinoma. N Engl J Med. 2020;383:1218-30.