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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...
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).
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).
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...
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...
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...
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...
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...
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...
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...
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 ...
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...
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...
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...
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...
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)...
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).
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).
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).
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).
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...
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...
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...
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 ...
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 ...
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...
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.
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...
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...
Two studies presented at the 2022 ASCO Genitourinary Cancers Symposium explored the role of poly (ADP-ribose) polymerase (PARP) inhibitors in urothelial cancer: ATLANTIS and BAYOU.1,2 Results suggest that PARP inhibitors may be useful in certain genetic subgroups and perhaps in combination with...
In a phase II study (TITAN-TCC) reported in the Journal of Clinical Oncology, Grimm et al found that a nivolumab/ipilimumab boost in patients with advanced urothelial cancer who did not respond to nivolumab monotherapy alone increased objective response rates, with the benefit being greatest in...
Neoadjuvant treatment with the antibody-drug conjugate enfortumab vedotin-ejfv achieved notable antitumor activity in patients with muscle-invasive bladder cancer who are ineligible for treatment with cisplatin, according to preliminary results for cohort H of the EV-103 trial reported at the 2022...
As reported in the Journal of Clinical Oncology by Pfister et al, the French phase III GETUG-AFU V05 VESPER trial showed a nonsignificant improvement in 3-year progression-free survival with dose-dense methotrexate, vinblastine, doxorubicin, and cisplatin (dd- MVAC) vs gemcitabine/cisplatin given...
The past year has witnessed tremendous advances in genitourinary oncology. I am pleased to review these findings in this year’s Genitourinary Oncology Almanac from The ASCO Post. I hope that you will find this roadmap helpful in highlighting a selection of these exciting developments. Checkpoint...
Neoadjuvant treatment with the antibody-drug conjugate enfortumab vedotin-ejfv achieved notable antitumor activity in patients with muscle-invasive bladder cancer who are ineligible for treatment with cisplatin, according to preliminary results for cohort H of the EV-103 trial reported at the 2022...
The VESPER phase III trial answers some key questions regarding the optimal management of muscle-invasive bladder cancer. The study found that the neoadjuvant regimen of dose-dense methotrexate, vinblastine, doxorubicin, and cisplatin (dd-MVAC) was superior to standard gemcitabine/cisplatin in...
As reported inThe New England Journal of Medicine by Dean F. Bajorin, MD, of the Department of Medicine, Memorial Sloan Kettering Cancer Center, and colleagues, an interim analysis of the phase III CheckMate 274 trial has shown improved disease-free survival with adjuvant nivolumab vs placebo...
As reported in The New England Journal of Medicine by Thomas Powles, MD, of Barts Cancer Centre, Queen Mary University of London, and colleagues, a prespecified interim analysis of the phase III EV-301 trial has shown improved overall survival with the antibody-drug conjugate enfortumab...
In a cohort of the phase II TROPHY-U-01 trial reported in the Journal of Clinical Oncology, Scott T. Tagawa, MD, MS, of Weill Cornell Medicine, New York, and colleagues, found that the antibody-drug conjugate sacituzumab govitecan-hziy produced durable responses in patients with metastatic...
Sumanta K. Pal, MD, of City of Hope National Medical Center, discusses some key research developments in kidney cancer, including data on nivolumab and ipilimumab with or without CBM588 in metastatic renal cell carcinoma; intestinal microbiome associated with the development of grade 3 or 4 adverse events in patients with metastatic disease who have been treated with nivolumab plus ipilimumab and probiotic support; the link between TERT promoter mutations and clinical outcome with immune checkpoint inhibitor therapy for advanced urothelial cancer; mutations in the androgen receptor gene in patients with prostate cancer receiving novel androgen deprivation treatments; and findings on waning antibody titers in patients who have received COVID-19 vaccinations (Roundup of Abstracts 371, 561, 374, Posters 38 and 48).
Laura Bukavina, MD, MPH, a Urologic oncology fellow at Fox Chase Cancer Center, has been awarded the ASCO Genitourinary Conquer Cancer Merit Award. She presented the winning abstract, which characterizes the gut microbiome of patients with bladder cancer, at the 2022 ASCO Genitourinary (GU) Cancers ...
Petros Grivas, MD, PhD, of the University of Washington and Fred Hutchinson Cancer Research Center, discusses results from Cohort 3 of the TROPHY-U-01 study, which assessed sacituzumab govitecan-hziy in combination with pembrolizumab in patients with metastatic urothelial cancer who experienced disease progression after platinum-based regimens (Abstract 434).
Massimo Di Maio, MD, of the University of Turin, discusses the Meet-URO12 study, which showed that maintenance niraparib plus best supportive care (BSC) did not prolong progression-free survival, compared with BSC alone, among patients with urothelial cancer that did not progress after first-line platinum-based chemotherapy.
Jonathan E. Rosenberg, MD, of Memorial Sloan Kettering Cancer Center, discusses phase II findings from the BAYOU trial, which studied durvalumab in combination with olaparib for first-line treatment of platinum-ineligible patients with unresectable, stage IV urothelial carcinoma. Because secondary analyses indicated a potential progression-free survival benefit with this combination, there may be a role for PARP inhibitors in the treatment of advanced disease with homologous recombination repair mutation (Abstract 437).
Karen E. Knudsen, PhD, MBA, Chief Executive Officer of the American Cancer Society, discusses ways to address the inequities in genitourinary screening, treatment, and outcomes. Her suggestions focus on increasing awareness of screening, identifying risk factors, the dramatic rise in incidence among Hispanic individuals, and the basis for increased mortality in Black men.
Wesley Yip, MD, of Memorial Sloan Kettering Cancer Center, discusses phase II results on neoadjuvant gemcitabine and cisplatin for high-grade upper tract urothelial carcinoma, which was well tolerated and demonstrated a favorable pathologic response rate. Dr. Yip notes that this treatment, given prior to nephroureterectomy, did not significantly delay surgery or increase perioperative complication rates.
Simon J. Crabb, PhD, MBBS, of the Southampton Experimental Cancer Medicine Centre, discusses data from the ATLANTIS trial, in which the authors hypothesized that switch maintenance therapy with the PARP inhibitor rucaparib, in patients who have derived clinical benefit from first-line chemotherapy, may improve outcomes for those with metastatic urothelial carcinoma that harbored a composite biomarker for DNA repair deficiency (Abstract 436).
In a study reported in the Journal of Clinical Oncology, Owens-Walton et al found that minority populations are underrepresented in phase II and III trials targeting prostate, kidney, and bladder cancers taking place in the United States. Study Details In the analysis, the ClinicalTrials.gov...
Daniel P. Petrylak, MD, of Yale Cancer Center, discusses new data on the antitumor activity of neoadjuvant treatment with enfortumab vedotin-ejfv monotherapy in patients with muscle-invasive bladder cancer who are not eligible for cisplatin.
Long-term survival data from the first prospective, randomized biomarker validation trial in patients with muscle-invasive bladder cancer being treated with cisplatin-based chemotherapy before surgery are being reported at the 2022 ASCO Genitourinary Cancers Symposium by Thomas W. Flaig, MD, and...