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Researchers have found that the loss of the Y chromosome, a common impact of the aging process in men, may help cancer cells evade the body’s immune system and result in aggressive bladder cancer—but it may also render the disease more vulnerable and responsive to immune checkpoint...
In a study reported in JAMA Network Open, Weinberg et al found that receipt of the bacillus Calmette-Guérin (BCG) vaccine in patients with non–muscle-invasive bladder cancer was associated with a lower risk of Alzheimer’s disease and related dementias—as well as a lower risk of mortality—compared...
In a Korean cohort study reported in JAMA Network Open, An et al found that men with prescriptions for 5α-reductase inhibitors prior to diagnosis of urothelial bladder cancer had better outcomes than those with no prior prescriptions. Study Details The study analyzed patient claims data from the...
Three clinical trials demonstrated positive results from the targeted therapy erdafitinib for patients with multiple tumor types harboring FGFR alterations. The data were presented at the 2023 ASCO Annual Meeting. Erdafitinib is an oral medication that blocks the activity of FGFR signaling...
Arlene O. Siefker-Radtke, MD, of The University of Texas MD Anderson Cancer Center, discusses the combination of erdafitinib and cetrelimab, which demonstrated clinically meaningful activity and was well tolerated in cisplatin-ineligible patients with metastatic urothelial carcinoma and fibroblast growth factor receptor alterations (Abstract 4504).
Arlene O. Siefker-Radtke, MD, of The University of Texas MD Anderson Cancer Center, discusses phase III findings showing that for patients with advanced or metastatic urothelial carcinoma and FGFR alteration who already had been treated with a PD-(L)1 inhibitor, erdafitinib significantly improved overall and progression-free survival, as well as overall response rate, compared with investigator’s choice of chemotherapy (LBA4619).
Christian Pfister, MD, PhD, of Rouen University Hospital, discusses phase III results from the VESPER trial, which showed that dose-dense methotrexate, vinblastine, doxorubicin, and cisplatin provided a better overall survival rate at 5 years and improved disease-specific survival compared with gemcitabine as perioperative chemotherapy in patients with muscle-invasive bladder cancer (Abstract LBA4507).
Shilpa Gupta, MD, of Cleveland Clinic, discusses the results from the EV-103 study and the unmet need for effective first-line therapies in cisplatin-ineligible patients with locally advanced or metastatic urothelial carcinoma. After nearly 4 years of follow-up, the trial findings showed that enfortumab vedotin-ejfv plus pembrolizumab continues to demonstrate promising survival trends with rapid and durable responses in this population (Abstract 4505).
Enrique Grande, MD, of The University of Texas MD Anderson Cancer Center, discusses new findings that show initial responses to induction therapy with atezolizumab plus platinum and gemcitabine did not seem to impact overall survival for patients with metastatic urothelial carcinoma. Cisplatin-treated patients appeared to derive a greater benefit with atezolizumab than did carboplatin-treated patients (Abstract 4503).
Patients with muscle-invasive bladder cancer who receive fewer than three cycles of chemotherapy prior to cystectomy may have an increased risk of cancer recurrence and worse survival outcomes, according to the findings of a retrospective study presented by Chakraborty et al at the 2023 ASCO Annual ...
Extended lymphadenectomy in patients undergoing radical cystectomy for clinically localized muscle-invasive bladder cancer was not associated with improved disease-free survival or overall survival and may increase the risk of adverse events and postsurgical mortality, according to new findings...
Researchers have developed a new strategy to identify which patients with non–muscle-invasive bladder cancer may be most likely to resist first-line treatment with Bacillus Calmette-Guérin (BCG) immunotherapy, according to a new study published by Jong et al in Science Translational Medicine. The...
Researchers have found that patients treated with the Bacillus Calmette-Guérin (BCG) vaccine may have a reduced risk of Alzheimer’s disease and related dementias, according to a novel study published by Weinberg et al in JAMA Network Open. Background The BCG vaccine has been known to offer multiple ...
In a retrospective analysis reported in The Lancet Oncology, Zlotta et al found that trimodality therapy was associated with similar outcomes compared to radical cystectomy in patients with muscle-invasive bladder cancer. Study Details The study involved 722 patients with clinical stage T2–T4N0M0...
In a single-center trial reported in JAMA Surgery, Shinall et al found that specialist palliative care did not improve quality of life or survival vs usual care in patients undergoing nonpalliative major abdominal surgery for cancer. Study Details In the trial, 235 patients scheduled for specified...
Although hypomethylating agents previously appeared to be a promising treatment option for patients with bladder cancer refractory to immunotherapy, researchers were forced to halt a recent phase II clinical trial after patients experienced either no response to treatment or rapid tumor...
On April 3, 2023, enfortumab vedotin-ejfv with pembrolizumab was granted accelerated approval for patients with locally advanced or metastatic urothelial carcinoma ineligible for cisplatin-containing chemotherapy.1,2 Enfortumab vedotin-ejfv is an antibody-drug conjugate targeting nectin 4....
The American Urological Association (AUA), in partnership with the Society of Urologic Oncology (SUO), have released recommendations for the diagnosis and management of patients with nonmetastatic upper tract urothelial carcinoma. The new clinical practice guidelines were published by Coleman et al ...
An updated analysis of the phase III JAVELIN Bladder 100 trial continued to show benefits in overall survival and progression-free survival with avelumab maintenance plus best supportive care vs best supportive care alone in patients with advanced urothelial carcinoma who were progression-free...
In an analysis reported in JAMA Network Open, Zhu et al found that immune checkpoint inhibitor treatment did not appear to be associated with long-term survival in patients with metastatic urothelial cancer. Study Details The analysis included data from six trials of pembrolizumab, avelumab, and...
Researchers have found that the novel intravesical chemotherapy delivery system TAR-200 may be safe and effective for patients with advanced muscle-invasive bladder cancer who are medically unfit for standard treatment, according to a new study published by Tyson et al in The Journal of Urology....
Arlene O. Siefker-Radtke, MD, of The University of Texas MD Anderson Cancer Center, provides an overview of the emerging treatments for urothelial cancer, including several new agents in the antibody-drug conjugate and tyrosine kinase inhibitor classes. She describes the clinical activity and toxicities of enfortumab vedotin-ejfv, erdafitinib, and sacituzumab govitecan-hziy.
On April 3, the U.S. Food and Drug Administration (FDA) granted accelerated approval to the antibody-drug conjugate enfortumab vedotin-ejfv (Padcev) in combination with the PD-1 inhibitor pembrolizumab (Keytruda) for patients with locally advanced or metastatic urothelial carcinoma who are...
In a study reported in the Journal of Clinical Oncology, Sarfaty et al identified novel genetic subtypes of urothelial carcinoma exhibiting different responses to immune checkpoint blockade. Study Details In the multicenter study, whole-exome sequencing was performed on tumor specimens from 88...
Xin Gao, MD, Assistant Professor, Harvard Medical School, Genitourinary Cancers Program, Mass General Cancer Center, commented on the results from TROPHY-U-01 cohort 2. “These data add to the overall data on the efficacy of sacituzumab govitecan in patients with metastatic urothelial cancer. This...
Treatment with the antibody-drug conjugate sacituzumab govitecan-hziy achieved an objective response rate of 32% in platinum-ineligible patients with metastatic urothelial cancer who experienced disease progression on an immune checkpoint inhibitor, according to the primary analysis of the...
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...
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...
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...
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,...
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).
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)
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...
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).
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).
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).
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).
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).
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...
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...
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...
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...
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...
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...
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...
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...
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...
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).