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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Fred Saad, MD, of the University of Montreal Health Centre, discusses phase III findings demonstrating for the first time the clinical benefits of olaparib plus abiraterone in patients with metastatic castration-resistant prostate cancer, irrespective of their homologous recombination repair mutation status. This regimen led to significantly longer radiographic progression-free survival than placebo plus abiraterone (Abstract 11).
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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.
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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.
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Axel S. Merseburger, MD, of the University Hospital Schleswig-Holstein, discusses results from a phase IIIb study of chemotherapy-naive patients with metastatic castration-resistant prostate cancer who have been treated with docetaxel plus prednisolone and experienced disease progression on enzalutamide. The data suggest that continued enzalutamide plus docetaxel improved progression-free survival compared with placebo plus docetaxel (Abstract 15).
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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).