August 25, 2020 - Supplement: Genitourinary Cancers Almanac (View All Issues)
Genitourinary Oncology Highlights 2019–2020 Almanac
Over the past year, we have seen significant advances in the treatment of prostate, kidney, and urothelial cancers that will benefit patients now and in the future. We have learned about the final results of important clinical trials across multiple genitourinary cancers disease states leading to
Lutetium-177–Labeled PSMA-617 Improves PSA Response in First Analysis From TheraP Trial in Metastatic Prostate Cancer
Initial results of the randomized phase II TheraP trial showed that therapy directed to prostate-specific membrane antigen (PSMA) with lutetium-177–labeled PSMA-617 (LuPSMA) significantly improved prostate-specific antigen (PSA) response compared with cabazitaxel in men with metastatic...
In Biochemically Recurrent Prostate Cancer, PSMA-Targeted PET/CT Imaging May Be Useful
Positron-emission tomography/computed tomography (PET/CT) imaging with the prostate-specific membrane antigen (PSMA)-targeted radiotracer fluorine F-18 DCFPyL (PyL) successfully identified areas of occult metastasis in men with biochemically recurrent metastatic castration-resistant prostate...
Androgen Deprivation With Oral Relugolix vs Leuprolide in Advanced Prostate Cancer: HERO Trial
As reported at the ASCO20 Virtual Scientific Program1 and in The New England Journal of Medicine2 by Neal D. Shore, MD, FACS, of Carolina Urologic Research Center, Myrtle Beach, South Carolina, and colleagues, the phase III HERO trial showed sustained castrate testosterone levels and lower risk of...
Final Overall Survival Analysis of the PROSPER Trial in Nonmetastatic Castration-Resistant Prostate Cancer
In the final overall survival analysis of the phase III PROSPER trial reported at the ASCO20 Virtual Scientific Program1 and published in The New England Journal of Medicine,2 Cora N. Sternberg, MD, and colleagues found that enzalutamide plus androgen-deprivation therapy (ADT) significantly...
Final Analysis of the ARAMIS Trial in Men With Nonmetastatic Castration-Resistant Prostate Cancer
A year ago, initial results from the double-blind, multicenter, randomized phase III ARAMIS clinical trial evaluating the efficacy and safety of darolutamide, a structurally unique androgen-receptor antagonist, in men with nonmetastatic castration-resistant prostate cancer, were published in The...
Phase III Study of AR Antagonist in Nonmetastatic Castration-Resistant Prostate Cancer
In the phase III ARAMIS trial reported in The New England Journal of Medicine,1 Karim Fizazi, MD, PhD, of the Institut Gustave Roussy, Universite Paris-Sud, Villejuif, France, and colleagues found that the androgen-receptor (AR) antagonist darolutamide significantly prolonged metastasis-free...
Nonmetastatic Castration-Resistant Prostate Cancer
Nonmetastatic castration-resistant prostate cancer arises in the subset of men with biochemically recurrent disease (ie, rising prostate-specific antigen [PSA] level after definitive therapy in the absence of metastases) who develop PSA progression after chronic exposure to androgen-deprivation...
Phase II TRITON2 Study in Metastatic Castration-Resistant Prostate Cancer
The single-arm TRITON2 study demonstrated the efficacy of the poly (ADP-ribose) polymerase (PARP) inhibitor rucaparib in patients with metastatic castration-resistant prostate cancer.1,2 Results from the study (ClinicalTrials.gov identifier NCT02952534) led to the approval of rucaparib in this...
TITAN Trial: Apalutamide Adds to Options for Men With Metastatic Hormone-Sensitive Prostate Cancer
Androgen-deprivation therapy has been, and remains, the standard of care for patients with metastatic prostate cancer. Patients are often surprised to learn that was all we would do to control their disease and sometimes asked why they would not receive chemotherapy, as for other cancers. I would...
Enzalutamide Improves Survival vs Standard First-LineTreatment in Hormone-Sensitive Metastatic Prostate Cancer
As reported inThe New England Journal of Medicine by Ian D. Davis, MBBS, PhD, FRACP, FAChPM, of Monash University and Eastern Health in Melbourne, and colleagues, the phase III ENZAMET trial has shown that the androgen receptor inhibitor enzalutamide improved progression-free and overall survival ...
Many Choices Now for Men With Metastatic Hormone-Sensitive Prostate Cancer: How to Decide?
Based on the recently published ENZAMET, ARCHES, and TITAN trials,1-3 we now have several choices of systemic combination therapies for men with metastatic hormone-sensitive prostate cancer. Today, men are faced with decisions of androgen-deprivation therapy alone or combinations with abiraterone,...
Novel Indications and New Drugs for Castration-Resistant or Castrate-Sensitive Prostate Cancer
The past year has witnessed the U.S. Food and Drug Administration (FDA) approval of a number of drugs for treatment of patients with metastatic castrate-resistant prostate cancer or castrate-sensitive prostate cancer.
Castrate-Resistant Prostate Cancer
Olaparib: On May 19, 2020, olaparib...
Addition of Apalutamide to Androgen-Deprivation Therapy in Metastatic Castration-Sensitive Prostate Cancer
As reported in The New England Journal of Medicine by Kim N. Chi, MD, of BC Cancer and Vancouver Prostate Centre, and colleagues, the first analysis of the phase III TITAN trial has shown that the addition of apalutamide to androgen-deprivation therapy improved radiographic progression-free and...
Study Supports Pembrolizumab Plus Axitinib in Previously Untreated Advanced Renal Cell Carcinoma
Extended analysis of the phase III KEYNOTE-426 study upholds pembrolizumab plus axitinib as a preferred front-line regimen over sunitinib in patients with advanced sporadic renal cell carcinoma.1 These updated results were presented during the ASCO20 Virtual Scientific Program by Elizabeth R....
Immune Checkpoint Inhibitor Rechallenge in Metastatic Renal Cell Carcinoma
In a study presented during the ASCO20 Virtual Scientific Program1 and published as a brief report in JAMA Oncology,2 Praful Ravi, MB, BChir, of the Dana-Farber Cancer Institute, Boston, and colleagues found that rechallenge with immune checkpoint inhibitor therapy was capable of producing...
Novel Indications and New Drugs for the Treament of Patients With Renal Cell Carcinoma
Pembrolizumab Plus Axitinib: On April 19, 2019, pembrolizumab (Keytruda) was approved for use in combination with the small-molecule tyrosine kinase inhibitor axitinib (Inlyta) for the first-line treatment of patients with advanced renal cell carcinoma. Approval was based on findings in the phase...
First-Line Combination Treatments Improve Outcomes vs Sunitinib in Advanced Renal Cell Carcinoma
Two recently reported phase III trials have shown the benefits of combination therapy vs sunitinib in the first-line treatment of advanced renal cell carcinoma. As reported in The New England Journal of Medicine by Brian I. Rini, MD, of Cleveland Clinic Taussig Cancer Institute, and colleagues, the ...
Salvage Nivolumab Plus Ipilimumab After Prior Immune Checkpoint Inhibitor Therapy in Patients With Metastatic Renal Cell Carcinoma
In a study reported in the Journal of Clinical Oncology,1 Anita Gul, MD, of the Cleveland Clinic Taussig Cancer Institute, and colleagues found that salvage therapy with nivolumab/ipilimumab was capable of producing a response after prior PD-1 pathway inhibitor therapy in some patients with...
Maintenance Avelumab Improves Survival in Advanced Bladder Cancer
Maintenance therapy with avelumab and best supportive care significantly prolonged overall survival vs best supportive care alone in patients with advanced urothelial carcinoma that did not progress on first-line platinum-based chemotherapy, according to an interim analysis of the phase III JAVELIN ...
Erdafitinib in FGFR-Altered Advanced Urothelial Carcinoma
As reported in The New England Journal of Medicine by Loriot et al, the fibroblast growth factor receptor 1-4 tyrosine kinase inhibitor erdafitinib showed activity in FGFR-altered advanced urothelial carcinoma.1 The study enrolled patients from sites in 14 countries between May 2015 and March 2018. ...
Early Data Show Activity for Enfortumab Vedotin Plus Pembrolizumab in Advanced Bladder Cancer
It may be possible to use a platinum-free combination as first-line treatment for advanced or metastatic urothelial carcinoma in cisplatin-ineligible patients, if the results of the phase Ib/II EV-103 trial hold up. The combination of the newly approved antibody-drug conjugate (enfortumab vedotin)...
Novel Indications and New Drugs for the Treatment of Bladder Cancer
Pembrolizumab: On January 8, 2020, pembrolizumab (Keytruda) was approved by the U.S. Food and Drug Administration (FDA) for bacillus Calmette-Guérin (BCG)-unresponsive, high-risk, non–muscle invasive bladder cancer with carcinoma in situ with or without papillary tumors who are ineligible for or...
‘Switch Maintenance’ Pembrolizumab for Metastatic Urothelial Cancer
In a phase II study reported in the Journal of Clinical Oncology,1 Matthew D. Galsky, MD, of The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, and colleagues found that maintenance pembrolizumab produced additional responses and improved progression-free survival vs...
Long-Term Outcomes With Pembrolizumab for Cisplatin-Ineligible Advanced Urothelial Cancer
As reported in the Journal of Clinical Oncology by Jacqueline Vuky, MD, of Oregon Health & Science University, Portland, and colleagues, long-term follow-up in the phase II KEYNOTE-052 study has shown durable responses with first-line pembrolizumab in cisplatin-ineligible locally advanced or...
First-Line Atezolizumab Plus Platinum-Based Chemotherapy vs Chemotherapy Alone in Advanced Urothelial Cancer
As reported in The Lancet by Matthew D. Galsky, MD, of Icahn School of Medicine at Mount Sinai, Tisch Cancer Institute, New York, and colleagues, the phase III IMvigor130 trial has shown prolonged progression-free survival with first-line atezolizumab plus platinum-based chemotherapy vs...
