One of the most exciting presentations that I heard at ASCO 2014 – the sort that give you goosebumps and elicit a wow from people sitting next to you – was not in the plenary or even a tumour type oral session, but a clinical science symposium.

The subject? Bladder cancer.

The situation? Phase I clinical trial.

The therapy? Anti-PD-L1 therapy with MPDL3280A.

Prof Thomas Powles, Barts Cancer Institute, London

Prof Thomas Powles, Barts Cancer Institute, London

As the presenter, Prof Thomas Powles (Barts), dryly observed to the packed auditorium, it made a welcome change from the ten people who usually show up for bladder cancer sessions! After all, there have been no new approved therapies for this disease for some thirty years.

It wouldn’t have been out of place in the Plenary session, frankly.

By the time the ASCO selection committees cotton on to the fact what many of us know – that immuno-oncology is not only hot, but here to stay and actually changing the way we think about and treat some advanced cancers – some of these new checkpoint inhibitors will already be approved by the FDA.  As one thought leader grumpily said to me:

“It’s not something they understand, nor does it involve the traditional things like breast or prostate cancers, plus it’s all political anyway.”

Ouch. Still, there was a lot to learn from this data, not just in terms of the results in an area of high unmet medical need, but also in our understanding of the immune system and where some future opportunities lie.

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