Advertisement


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

2022 ASCO Annual Meeting

Advertisement

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).



Transcript

Disclaimer: This video transcript has not been proofread or edited and may contain errors.
The COSMIC-021 study is a trial that includes multiple different histologies, multiple different cohorts. At this year's ASCO meeting, ASCO 2022, I presented data pertaining to cohorts three, four, and five. This specifically looked at patients with advanced urothelial carcinoma. The composition of each of the cohorts was distinct. In cohort three, we had patients that were cisplatin-ineligible. In cohort four, patients that were cisplatin-eligible. And finally, in cohort five, patients that had received prior immune checkpoint inhibitors. What ultimately it boiled down to is about 30 patients per cohort. In terms of the distribution of patients, it was predominantly male, as you might expect. Most of the patients had a bladder primary, although we did actually have good representation of upper track tumors, ureteral tumors, and so forth. That was about 30% of the study population. Amongst those patients that had received prior immune checkpoint inhibitors, about 30% had received one prior therapy implying immune-based treatment, and about 68% had received two or more prior lines of treatment. What we saw was actually a graded response. In patients who were cisplatin-eligible we saw the highest response rate, 30%. In patients that cisplatin-ineligible we saw a response rate of 20%. And finally, in patients that had received prior immune checkpoint inhibitors, we saw a response rate of 10%. It's always tricky to know what endpoints to follow in these relatively small studies. One thing that really I found intriguing was the duration of response. And with substantial follow up at this point in time, we still haven't reached the median duration of response amongst those patients that were cisplatin-eligible. I really think that the toxicity profile that we saw in this study really mimics what we've seen in other experiences of cabozantinib with atezolizumab. The combination seems to be very well tolerated. We used a dose of cabozantinib at 40 milligrams. The rates of hepatitis, the rates of other toxicities that you'd expect with a combination like diarrhea, were very reasonable and manageable by and large. So in summary, I think that this combination really does have activity. My hope is that we'll be able to study it further in certain contexts. And in particular, there's a study ongoing right now that I'll plug, MAIN-CAV through the Alliance. It's led by Dr. Shilpa Gupta. This trial I think is a prime way for us to understand the role of cabozantinib with immunotherapy where that combination's being assessed in the maintenance setting.

Related Videos

Neuroendocrine Tumors

Mairéad G. McNamara, PhD, MBBCh, on Neuroendocrine Carcinoma: Findings on Liposomal Irinotecan Plus Fluorouracil and Folinic Acid or Docetaxel

Mairéad G. McNamara, PhD, MBBCh, of The Christie NHS Foundation Trust, discusses phase II findings of the NET-02 trial, which explored an unmet need in the second-line treatment of patients with progressive, poorly differentiated extrapulmonary neuroendocrine carcinoma. In the trial, the combination of liposomal irinotecan, fluorouracil, and folinic acid, but not docetaxel, met the primary endpoint of 6-month progression-free survival rate (Abstract 4005).

Michael J. Overman, MD, and Takayuki Yoshino, PhD, MD, on Colorectal Cancer: Phase III Data on Panitumumab or Bevacizumab Plus mFOLFOX6

Michael J. Overman, MD, of The University of Texas MD Anderson Cancer Center, and Takayuki Yoshino, PhD, MD, of the National Cancer Center Hospital East, Japan, discuss results from the PARADIGM trial, the first prospective study to test the superiority of panitumumab vs bevacizumab in combination with standard doublet first-line chemotherapy for patients with RAS wild-type and left-sided metastatic colorectal cancer. The study showed that panitumumab improved overall survival in combination with mFOLFOX6, which may establish a standard first-line combination regimen for this population (Abstract LBA1).

Pancreatic Cancer

Rainer Fietkau, MD, on Pancreatic Cancer: Initial Trial Results on Sequential Chemotherapy and Chemoradiotherapy

Rainer Fietkau, MD, of Germany’s University Hospital Erlangen, discusses phase III findings of the CONKO-007 trial, which examined the role of sequential chemotherapy and chemoradiotherapy administered to patients with nonresectable locally advanced pancreatic cancer following standard-of-care chemotherapy (Abstract 4008).

Breast Cancer

Robert Hugh Jones, MD, PhD, on Breast Cancer: Updated Overall Survival Data on Fulvestrant Plus Capivasertib

Robert Hugh Jones, MD, PhD, of Cardiff University and Velindre Hospital, discusses results from an updated analysis of the FAKTION trial, which showed improved overall survival with fulvestrant plus capivasertib in women with metastatic estrogen receptor–positive breast cancer whose disease had relapsed or progressed on an aromatase inhibitor. The benefit may be predominantly in patients with PIK3CA/AKT1/PTEN pathway–altered tumors, a topic researchers continue to study in the phase III CAPItello-291 trial (Abstract 1005).

 

Gynecologic Cancers
Immunotherapy

Ursula A. Matulonis, MD, and Ignace Vergote, MD, PhD, on Cervical Cancer: Interim Results on Tisotumab Vedotin-tftv Plus Pembrolizumab

Ursula A. Matulonis, MD, of Dana-Farber Cancer Institute, and Ignace Vergote, MD, PhD, of Belgium’s University Hospitals Leuven, discuss interim safety and efficacy results from a third dose-expansion cohort evaluating first-line tisotumab vedotin-tftv plus pembrolizumab in patients with recurrent or metastatic cervical cancer. Data on the combination showed durable antitumor activity with a manageable safety profile (Abstract 5507).

Advertisement

Advertisement




Advertisement