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Bladder Cancer

AI-Based Model for Nodal Metastasis Detection Using Whole-Slide Images in Bladder Cancer

In a Chinese study reported in The Lancet Oncology, Wu et al found that an artificial intelligence (AI)-based lymph node metastases diagnostic model using whole-slide images performed well in identifying lymph node metastases in patients with bladder cancer, as well as other cancers. Study Details...

Bladder Cancer
Genomics/Genetics

Novel Urine Test May Play a Role in Bladder Cancer Prediction

Testing for genetic mutations in urine may help clinicians detect bladder cancer years before the disease shows clinical symptoms, according to new findings presented by Le Calvez-Kelm et al at the 2023 European Association of Urology Annual Congress (Abstract A0268). The researchers identified...

Bladder Cancer
Immunotherapy

Nivolumab Followed by Nivolumab/Ipilimumab Boosting in Nonresponders Among Previously Treated Patients With Advanced Urothelial Carcinoma

In a German-Austrian phase II study (TITAN-TCC) reported in The Lancet Oncology, Grimm et al found that a strategy of nivolumab monotherapy followed by immunotherapeutic boosting including high-dose ipilimumab in nivolumab nonresponders showed activity in patients with unresectable or metastatic...

Bladder Cancer

CheckMate 274: Continued Disease-Free Survival Benefits With Adjuvant Nivolumab in High-Risk Urothelial Carcinoma

With longer-term follow-up, adjuvant nivolumab continued to demonstrate improved disease-free survival, non–urothelial tract recurrence–free survival, and distant metastasis–free survival vs placebo in patients with muscle-invasive urothelial carcinoma at high risk of recurrence after surgery,...

bladder cancer

Vadim S. Koshkin, MD, and Tanya Jindal, BS, BA, on Urothelial Carcinoma: Biomarkers of Response to Enfortumab Vedotin-ejfv

Vadim S. Koshkin, MD, and Tanya Jindal, BS, BA, both of the University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, discuss results from the retrospective UNITE study of biomarkers of response to the antibody-drug conjugate enfortumab vedotin-ejfv in patients with advanced urothelial carcinoma. Enfortumab vedotin is used widely in treatment-refractory disease, but there have been limited data available on biomarkers that may predict outcomes with this treatment. The UNITE study has now identified several potential biomarkers that need to be validated to help inform clinical decision-making and therapy sequencing. (Abstract 450).

bladder cancer
kidney cancer
prostate cancer

Updates From City of Hope on Renal Cell, Prostate, and Urothelial Cancers

Sumanta K. Pal, MD, introduces his City of Hope colleagues, Hedyeh Ebrahimi, MD, MPH, who discusses the prevalence of dietary modification and supplement use in patients with metastatic renal cell carcinoma, and Daniela Castro, MSc, who discusses expanding eligibility criteria in kidney, prostate, and urothelial cancer trials to more accurately reflect the real-world population and reducing exclusion criteria. (Abstract 662, 612, 34, 453)

Bladder Cancer

Combination Chemotherapy May Be Safe and Effective Alternative for the Treatment of Patients With Non–Muscle-Invasive Bladder Cancer Amid BCG Shortage

Researchers have found that a safe, inexpensive chemotherapy combination may be better tolerated and more effective at preventing high-grade recurrence in patients with non–muscle-invasive bladder cancer than the standard-of-care bacillus Calmette-Guérin (BCG), according to a novel study published...

bladder cancer

Daniel P. Petrylak, MD, on Urothelial Cancer: Phase II Trial Analysis of Sacituzumab Govitecan-hziy in Metastatic Disease

Daniel P. Petrylak, MD, of the Yale Cancer Center, discusses a primary phase II analysis of the TROPHY-U-01 study, cohort 2, which evaluated sacituzumab govitecan-hziy in platinum-ineligible patients with metastatic urothelial cancer that progressed after prior checkpoint inhibitor therapy. (Abstract 520).

bladder cancer

Matt D. Galsky, MD, on Bladder or Upper Urinary Tract Cancer: Extended Follow-up Results From CheckMate 274

Matt D. Galsky, MD, of the Icahn School of Medicine at Mount Sinai and Tisch Cancer Institute, discusses results from CheckMate 274, which investigated nivolumab compared with placebo in patients with bladder or upper urinary tract cancer, following radical surgery to remove invasive disease. (Abstract LBA443).

bladder cancer

Matt D. Galsky, MD, on Urothelial Carcinoma: New Study Results on Atezolizumab, Platinum, and Gemcitabine

Matt D. Galsky, MD, of the Icahn School of Medicine at Mount Sinai and Tisch Cancer Institute, discusses final overall survival data from the phase III IMvigor130 study, which compared atezolizumab versus placebo, both of which were paired with platinum and gemcitabine in the first-line treatment of patients with locally advanced or metastatic urothelial carcinoma. (Abstract LBA440).

bladder cancer

Andrea Necchi, MD, on Bladder Cancer: Phase II Results With Pembrolizumab Monotherapy

Andrea Necchi, MD, of Italy’s Vita-Salute San Raffaele University and the IRCCS San Raffaele Hospital and Scientific Institute, discusses new data from the KEYNOTE-057 trial on a novel systemic therapy for papillary high-risk non–muscle-invasive bladder cancer. The findings suggest that patients whose disease does not respond to bacillus Calmette-Guérin or who declined or were ineligible for a radical cystectomy may benefit from pembrolizumab monotherapy. (Abstract LBA442).

bladder cancer

Aristotelis Bamias, MD, on Urothelial Carcinoma: Final Overall Survival Analysis of Atezolizumab Monotherapy vs Chemotherapy

Aristotelis Bamias, MD, of the National and Kapodistrian University of Athens, discusses results from the phase III IMvigor130 study, which suggest that atezolizumab monotherapy continues to show better tolerability vs chemotherapy for patients with untreated locally advanced or metastatic urothelial carcinoma. (Abstract LBA441).

Bladder Cancer
Immunotherapy

Nivolumab After Surgical Resection Improves Disease-Free Survival for Patients With High-Risk Muscle-Invasive Urothelial Carcinoma

Adjuvant therapy with the immune checkpoint inhibitor nivolumab following surgery improved disease-free survival in patients with high-risk muscle-invasive urothelial carcinoma, according to new findings presented by Matthew D. Galsky, MD, FASCO, and colleagues at the 2023 ASCO Genitourinary...

Bladder Cancer

Single-Arm Phase II Noninferiority Trial Evaluates Active Surveillance vs Cystectomy Following Neoadjuvant Chemotherapy for Muscle-Invasive Urothelial Carcinoma

Researchers have found that following chemotherapy, 46% of patients with muscle-invasive urothelial carcinoma were able to avoid a cystectomy and achieve a 2-year metastasis-free survival, according to new findings presented by Daniel M. Geynisman, MD, and colleagues at the 2023 ASCO Genitourinary...

Bladder Cancer

First Adenoviral Vector–Based Gene Therapy for High-Risk BCG-Unresponsive Non–Muscle-Invasive Bladder Cancer

On December 16, 2022, nadofaragene firadenovec-vncg, an adenoviral vector–based gene therapy, was approved for patients with high-risk bacillus Calmette-Guérin (BCG)-unresponsive non–muscle-invasive bladder cancer with carcinoma in situ with or without papillary tumors.1 Supporting Efficacy Data...

Bladder Cancer

Study Reports Activity With Oncolytic Vaccine Plus Pembrolizumab in BCG-Unresponsive Bladder Cancer

An oncolytic therapy delivered within the urinary bladder in combination with pembrolizumab has yielded high complete response rates in patients with bacillus Calmette-Guérin (BCG)-unresponsive bladder cancer, according to data presented by Roger Li, MD, lead study investigator and urologic...

Bladder Cancer

Neoadjuvant Gemcitabine/Cisplatin in High-Risk Upper Tract Urothelial Carcinoma

In a phase II trial reported in the Journal of Clinical Oncology, Coleman et al found that neoadjuvant split-dose gemcitabine and cisplatin produced a high rate of pathologic response in patients with high-risk localized upper tract urothelial carcinoma. The investigators also showed that...

Bladder Cancer

Mitomycin Gel for Upper Tract Urothelial Cancers: Postmarket Analysis

Researchers have performed the first postmarkert analysis of a novel delivery system of mitomycin—a gel formation, also known as UGN-101—to treat upper tract urothelial cancers, according to a novel study published by Woldu et al in Urologic Oncology. Their findings showcase how the treatment is...

Prostate Cancer
Bladder Cancer
Kidney Cancer

Study Examines Genitourinary Cancer Trends, Disparities in the United States

New findings revealed that the highest mortality rates for prostate cancer among White male patients were found in the Western United States—including California—despite low incidence rates, according to a new study published by Schafer et al in European Urology. However, when compared with White...

Bladder Cancer

FDA Approves First Gene Therapy for High-Risk Non–Muscle-Invasive Bladder Cancer

On December 16, the U.S. Food and Drug Administration (FDA) approved nadofaragene firadenovec-vncg (Adstiladrin), a nonreplicating adenoviral vector–based gene therapy indicated for the treatment of adult patients with high-risk bacillus Calmette-Guérin (BCG)-unresponsive non–muscle-invasive...

Bladder Cancer

Study Reports Activity With Oncolytic Vaccine Plus Pembrolizumab in BCG-Unresponsive Bladder Cancer

An oncolytic therapy delivered within the urinary bladder in combination with pembrolizumab has yielded the “best results seen in the field” in patients with bacillus Calmette-Guérin (BCG)-unresponsive bladder cancer, according to data presented during the 2022 Society for Immunotherapy of Cancer...

Bladder Cancer

DNA Repair Protein MRE11 Expression and Disease-Specific Mortality Among Patients With Muscle-Invasive Bladder Cancer Receiving Trimodality Therapy

In a retrospective analysis reported in JAMA Network Open, Magliocco et al found that among patients with muscle-invasive bladder cancer receiving bladder-preserving trimodality therapy, those with a lower expression of the DNA repair protein MRE11 had significantly poorer disease-specific...

bladder cancer
immunotherapy

Roger Li, MD, on Bladder Cancer: Boosting Immune Checkpoint Blockade With an Oncolytic Adenovirus

Roger Li, MD, of the H. Lee Moffitt Cancer Center, discusses results from a phase II single-arm study of CG0070, a cancer-selective oncolytic adenovirus that creates mechanistic synergy with immune checkpoint blockade. In this trial, the virus was combined with pembrolizumab in patients with non–muscle-invasive bladder cancer that is unresponsive to bacillus Calmette-Guérin. At 3 months, 88% of the 35 patients enrolled achieved a complete response (Abstract 666).

bladder cancer
immunotherapy

Jonathan E. Rosenberg, MD, on Urothelial Cancer: Results From EV-103, Cohort K on Enfortumab Vedotin and Pembrolizumab

Jonathan E. Rosenberg, MD, of Memorial Sloan Kettering Cancer Center, discusses recent findings on the safety and antitumor activity of enfortumab vedotin-ejfv given intravenously as monotherapy or in combination with pembrolizumab to previously untreated cisplatin-ineligible patients with locally advanced or metastatic urothelial cancer (Abstract LBA73).

Bladder Cancer

Rogaratinib vs Chemotherapy in Previously Treated Patients With Advanced Urothelial Carcinoma and FGFR1/3 mRNA Overexpression

As reported in the Journal of Clinical Oncology by Cora N. Sternberg, MD, and colleagues, interim analysis of the phase II portion of the phase II/III FORT-1 trial has shown similar objective response rates with the oral FGFR1–4 inhibitor rogaratinib vs chemotherapy in previously treated patients...

Bladder Cancer

Intensive Chemoresection With Mitomycin to Reduce the Need for Surgical Procedures in Patients With Recurrent Non–Muscle-Invasive Bladder Cancer

In a Danish study (DaBlaCa-13) reported in the Journal of Clinical Oncology, Lindgren et al found that short-term intensive chemoresection with mitomycin reduced the need for surgical procedures in patients with recurrent non–muscle-invasive bladder cancer. Study Details The trial was conducted at...

Bladder Cancer
Immunotherapy

Enfortumab Vedotin Plus Pembrolizumab in Cisplatin-Ineligible Patients With Advanced Urothelial Cancer

In a phase Ib/II study reported in the Journal of Clinical Oncology, Christopher J. Hoimes, MD, and colleagues found that first-line enfortumab vedotin-ejfv plus pembrolizumab produced a high response rate and prolonged response durations in cisplatin-ineligible, previously untreated patients with...

Bladder Cancer
Immunotherapy

New Research From Cohort K of the EV-103 Trial of Enfortumab Vedotin for Patients With Urothelial Cancer

Researchers from Memorial Sloan Kettering (MSK) Cancer Center shared data on a treatment option for patients with bladder cancer at the European Society for Medical Oncology (ESMO) Congress 2022 (Abstract LBA73). Jonathan E. Rosenberg, MD, medical oncologist and Chief of the Genitourinary Oncology...

Bladder Cancer

Novel Pembrolizumab-Based Combination Under Study in Metastatic Urothelial Carcinoma

In a phase II trial reported in the Journal of Clinical Oncology, Sadeghi et al found that EphrinB2 inhibition with soluble EphB4-human serum albumin (sEphB4-HSA) plus pembrolizumab appeared to exert substantial activity in patients with metastatic urothelial carcinoma, particularly among patients...

Bladder Cancer

Rucaparib Maintenance After Platinum-Based Chemotherapy for Metastatic Urothelial Carcinoma

In a phase II trial reported in the Journal of Clinical Oncology, Simon J. Crabb, BSc, MBBS, MRCP, PhD, and colleagues found that maintenance therapy with the poly (ADP-ribose) polymerase (PARP) inhibitor rucaparib vs placebo was associated with prolonged progression-free survival in patients with...

Bladder Cancer
Immunotherapy

Genetics May Predict Bladder Cancer Immunotherapy Response

Investigators have identified genetic signatures that could predict whether tumors in patients with bladder and other cancers will respond to immunotherapy with immune checkpoint inhibitors. Their findings, published by You et al in the Journal of the National Cancer Institute, implicate DDR1- and...

Bladder Cancer
Immunotherapy

EAU22: ctDNA May Help to Predict Response to Atezolizumab in Patients With Bladder Cancer

Researchers who treated a group of patients with bladder cancer with the immunotherapy atezolizumab after they had undergone surgery have found that patients whose blood contained circulating tumor DNA (ctDNA) responded very well to the treatment. The study was presented at the European Association ...

Bladder Cancer

Addition of Olaparib to Durvalumab in Previously Untreated, Platinum-Ineligible Patients With Metastatic Urothelial Carcinoma

As reported in the Journal of Clinical Oncology by Jonathan E. Rosenberg, MD, and colleagues, the phase II BAYOU trial has shown no improvement in progression-free survival with the addition of the poly (ADP-ribose) polymerase (PARP) inhibitor olaparib to the anti–PD-L1 agent durvalumab in...

Bladder Cancer
Immunotherapy

Expert Point of View: Guru P. Sonpavde, MD

Guru P. Sonpavde, MD, Director of the Bladder Cancer Program at Dana-Farber Cancer Institute and a faculty member of Harvard Medical School, Boston, said these follow-up data from CheckMate 274 provide reassurance that the disease-free survival benefit is maintained with adjuvant nivolumab. “We...

Bladder Cancer
Immunotherapy

CheckMate 274: Adjuvant Immunotherapy Improves Disease-Free Survival in Metastatic Urothelial Cancer

Adjuvant nivolumab could become the standard of care for patients with metastatic bladder cancer, according to data presented at the American Urological Association (AUA) 2022 Annual Meeting.1 With longer follow-up, the results of the phase III CheckMate 274 trial showed that treatment with the...

Genomics/Genetics
Bladder Cancer

Real-World Uptake of FGFR-Alteration Testing and Gene-Targeted Therapy for Patients With Urothelial Cancer

In a study reported in a research letter in JAMA Oncology, Nimgaonkar et al found that less than half of patients with urothelial cancer who had received first-line platinum-based therapy underwent testing for FGFR alterations and that less than half of patients with susceptible alterations...

Bladder Cancer

Robotic Surgery Improves Perioperative Outcomes vs Open Radical Cystectomy in Bladder Cancer Trial

Patients who underwent robotic-assisted radical cystectomy with intracorporeal diversion spent fewer days in the hospital and experienced fewer complications compared with those who underwent open radical cystectomy, according to data presented at the 2022 American Urological Association (AUA)...

bladder cancer
immunotherapy

Thomas Powles, MD, PhD, and Jonathan E. Rosenberg, MD, on Urothelial Carcinoma: Long-Term Outcomes With Enfortumab Vedotin-ejfv vs Chemotherapy

Thomas Powles, MD, PhD, of Barts Health NHS Trust, Queen Mary University of London, and Jonathan E. Rosenberg, MD, of Memorial Sloan Kettering Cancer Center, discuss the 24-month findings from the phase III EV-301 trial, which suggest that enfortumab vedotin-ejfv continues to show a significant and consistent survival advantage over standard chemotherapy in patients with previously treated advanced urothelial carcinoma (Abstract 4516).

bladder cancer

Sumanta K. Pal, MD, on Urothelial Carcinoma: New Results on Cabozantinib Plus Atezolizumab

Sumanta K. Pal, MD, of City of Hope National Medical Center, discusses findings from the COSMIC-021 study, which showed that cabozantinib plus atezolizumab demonstrated encouraging clinical activity with manageable toxicity in patients with inoperable locally advanced or metastatic urothelial carcinoma. The combination was administered as first-line therapy in cisplatin-based chemotherapy–eligible and –ineligible patients and as second- or later-line treatment in those who received prior immune checkpoint inhibitors (Abstract 4504).

bladder cancer

Shilpa Gupta, MD, on Urothelial Cancer: Defining Who Is 'Platinum-Ineligible'

Shilpa Gupta, MD, of the Cleveland Clinic Foundation, discusses an updated consensus definition for standard therapy and clinical trial eligibility for patients with metastatic urothelial cancer who are platinum-ineligible, criteria that are proposed to guide treatment recommendations for this population. This may be especially important now that the U.S. Food and Drug Administration has restricted the use of first-line pembrolizumab to those who are considered platinum-ineligible (Abstract 4577).

bladder cancer

Karim Chamie, MD, on Bladder Cancer: Final Results on N-803 and Bacillus Calmette-Guérin

Karim Chamie, MD, of the University of California, Los Angeles, discusses final clinical results on combining the superagonist N-803 with bacillus Calmette-Guérin (BCG) in patients whose carcinoma in situ and high-grade non–muscle-invasive bladder cancers are unresponsive to BCG alone. Of note, cystectomy was avoided in more than 90% of patients with 2 years of follow-up (Abstract 4508).

Bladder Cancer

Postoperative Outcomes With Robot-Assisted vs Open Radical Cystectomy for Bladder Cancer

As reported in JAMA by Catto et al, the phase III iROC trial showed that robot-assisted radical cystectomy with intracorporeal urinary diversion resulted in better 90-day outcomes compared with open radical cystectomy in patients with bladder cancer. Study Details In the multicenter trial, 338...

Bladder Cancer
Immunotherapy

Longer Follow-up Shows Adjuvant Immunotherapy After Bladder Cancer Surgery May Be Associated With Reduced Disease Recurrence

Treatment with the anti–PD-1 therapy nivolumab after surgery helped reduce cancer recurrence in patients with urothelial cancer of the bladder or other sites in the urinary tract that had invaded the muscle and therefore posed a high risk for recurrence, according to clinical trial results...

Bladder Cancer
Genomics/Genetics

Report Finds Uptake of Erdafitinib for Urothelial Cancer May Be Limited, Despite Positive Real-World Survival Data

The first bladder cancer drug targeting a cancer-driving gene mutation has been used relatively little despite its clear efficacy in a clinical trial, suggests a report published as a research letter by Nimgaonkar et al in JAMA Oncology. Researchers analyzed a large, nationwide database of cancer...

Bladder Cancer

Mortality and Perioperative Outcomes With Open vs Robot-Assisted Radical Cystectomy for Bladder Cancer

In a Swedish population-based cohort study reported in JAMA Network Open, Mortezavi et al found that robot-assisted radical cystectomy with intracorporeal urinary diversion was associated with reduced all-cause mortality, reduced high-grade complications, and improved perioperative outcomes vs open ...

Bladder Cancer

AI May Assist Physicians in Better Assessing the Effectiveness of Bladder Cancer Treatment

In a small multi-institutional study, an artificial intelligence (AI)-based system improved providers’ assessments of whether patients with bladder cancer had complete response to chemotherapy before a radical cystectomy. These findings were published by Sun et al in Tomography. Yet the researchers ...

Bladder Cancer

Addition of Nintedanib to Neoadjuvant Gemcitabine/Cisplatin in Locally Advanced Muscle-Invasive Bladder Cancer

In the UK phase II NEOBLADE trial reported in The Lancet Oncology, Hussain et al found that the addition of nintedanib to neoadjuvant gemcitabine/cisplatin did not improve pathologic complete response rate in patients with locally advanced muscle-invasive bladder cancer. In the double-blind...

bladder cancer

Thomas W. Flaig, MD, on Bladder Cancer: New Treatment Options

Thomas W. Flaig, MD, of the University of Colorado Cancer Center, discusses the rapidly changing treatment landscape for patients with bladder cancer, including PD-1 and PD-L1 inhibitors now approved for urothelial carcinoma; a category 1 indication for pembrolizumab in metastatic disease, post-platinum treatment and for non–muscle-invasive bladder cancer; enfortumab vedotin-ejfv for subsequent-line use; and erdafitinib for those with select FGFR mutations.

Bladder Cancer
Immunotherapy

Expert Point of View: Guru P. Sonpavde, MD

Guru P. Sonpavde, MD, Director of the Bladder Cancer Program at Dana-Farber Cancer Institute, Boston, said the therapeutic landscape of urothelial cancer has been altered by PD-L1 inhibitors and antibody-drug conjugates. “The rationale for Cohort 3 was based on high response rates seen with a...

Bladder Cancer
Immunotherapy

Second-Line Combination Study in Urothelial Cancer

The combination of the antibody-drug conjugate sacituzumab govitecan-hziy and the immune checkpoint inhibitor pembrolizumab yielded antitumor activity as second-line therapy in patients with platinum-refractory, checkpoint inhibitor–naive, metastatic urothelial cancer, according to the results of...

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