Sumanta K. Pal, MD, on Advances in Genitourinary Cancer Treatment: Expert Perspective
2022 ASCO Genitourinary Cancers Symposium
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).
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Alfredo Berruti, MD, of Italy’s University of Brescia, discusses the first study to give adjuvant mitotane to patients with adrenocortical carcinoma, a rare disease with a high risk of relapse after radical surgery. Although theoretically this treatment may be clinically worthwhile, the findings suggest that the need for adjuvant mitotane should always be discussed on a case-by-case basis by the multidisciplinary team, and more study is warranted (Abstract 1).
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Alicia K. Morgans, MD, MPH, of Dana-Farber Cancer Institute, discusses findings from the largest digital survey conducted in patients with prostate cancer, allowing identification of unmet needs in the patient journey. Preliminary data suggest that lower rates of screening may correlate with higher rates of symptoms at diagnosis and potentially later-stage diagnosis.
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Xin Gao, MD, of Massachusetts General Hospital, discusses phase I/II findings on bavdegalutamide, an androgen receptor protein degrader, which showed clinical activity in heavily pretreated patients with metastatic castration-resistant prostate cancer who received one to two prior novel hormonal agents.
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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).
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Neil E. Fleshner, MD, MPH, of the Princess Margaret Cancer Centre, discusses phase II results from the ACDC-RP trial, which indicate a significant tumor response to neoadjuvant abiraterone acetate plus prednisone and leuprolide, with or without cabazitaxel, in patients with high-risk prostate cancer. Those who exhibited either a complete response or minimal residual disease experienced higher rates of progression-free survival. According to Dr. Fleshner, genomic efforts are underway to determine predictors of response.
