Advertisement


Christian Pfister, MD, PhD, on Bladder Cancer: New Overall Survival Data on Perioperative Chemotherapy

2023 ASCO Annual Meeting

Advertisement

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). 



Transcript

Disclaimer: This video transcript has not been proofread or edited and may contain errors.
Since 20 year, VESPER is the only randomized [inaudible 00:00:12] trial comparing the efficacy of GC or dose-dense MVAC in perioperative setting in muscle-invasive bladder cancer. On a period of 5 years, we randomized 500 patients in 28 French cancer centers. 56 patient in the neoadjuvant group and the [inaudible 00:00:36] majority, 88% of patient in the neoadjuvant group. The primary endpoint of the VESPER trial was a progression-free survival of 3 years, with [inaudible 00:00:49]. On [inaudible 00:00:52], we present the overall survival at 5 year, and the disease-specific survival of the trial. Dose-dense MVAC allow better overall survival at 5 years than GC in the perioperative setting. In the neoadjuvant group, overall survival was significantly higher, with a 5-year wait of 66 verus 57 persons. Moreover, dose-dense MVAC improved significantly disease-specific survival at 5 years in the perioperative setting. Interestingly, we stratified the 5-year overall survival curve by [inaudible 00:01:36], and dose cisplatin receive. This representation clearly divides the study population in three group, and confirms the importance of cumulative cisplatin dose. We have the first group pool of all survival with less than four full-dose cisplatin, median of overall survival for GC-arm with four full-dose cisplatin, and higher survival with dose-dense MVAC with four or more full-cisplatin dose. My take-home message are VESPER is worthy of milestone in the history of chemotherapy for muscle-invasive bladder cancer. Dose-dense MVAC provides a better overall survival at 5 years, and significantly improved disease-specific survival over GC in the perioperative setting. Our result confirms the indisputable superiority of dose-dense MVAC over GC as neoadjuvant chemotherapy. Finally, VESPER is practice-changing and showed tumoral impact on clinical cancer research in bladder cancer.

Related Videos

Myelodysplastic Syndromes

Guillermo Garcia-Manero, MD, on Myelodysplastic Syndromes: Luspatercept and Epoetin Alfa in Lower-Risk Disease

Guillermo Garcia-Manero, MD, of The University of Texas MD Anderson Cancer Center, discusses phase III findings from the COMMANDS trial. Compared with epoetin alfa, luspatercept improved red blood cell transfusion independence and erythroid response, as well as the duration of response in erythropoiesis-stimulating agent–naive, transfusion-dependent patients with lower‐risk myelodysplastic syndromes (Abstract 7003).

Skin Cancer
Immunotherapy

Omid Hamid, MD, on Advanced Melanoma: Durable Response With Fianlimab Plus Cemiplimab

Omid Hamid, MD, of The Angeles Clinic & Research Institute, discusses study findings on fianlimab plus cemiplimab-rwlc, which showed clinical activity in patients with advanced melanoma, comparing favorably with other approved combinations of immune checkpoint inhibitors in the same clinical setting. This is the first indication that dual LAG-3 blockade may produce a high level of activity with significant overall response rate after adjuvant anti–PD-1 treatment. A phase III trial of this regimen in treatment-naive patients with advanced melanoma is ongoing (Abstract 9501).

Kidney Cancer
Immunotherapy

Rana R. McKay, MD, and Brian I. Rini, MD, on Clear Cell RCC: New Data From KEYNOTE-426 on Pembrolizumab Plus Axitinib vs Sunitinib

Rana R. McKay, MD, of the University of California, San Diego, and Brian I. Rini, MD, of Vanderbilt-Ingram Cancer Center, discuss the 5-year follow-up results with the combination of a checkpoint inhibitor plus a VEGFR tyrosine kinase inhibitor as first-line treatment for patients with advanced clear cell renal cell carcinoma (RCC). Pembrolizumab plus axitinib continued to demonstrate improved survival outcomes as well as overall response rate vs sunitinib for patients with previously untreated disease (Abstract LBA4501).

Bladder Cancer

Enrique Grande, MD, on Metastatic Urothelial Carcinoma: Updated Data From IMvigor130

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).

Gynecologic Cancers

Bobbie J. Rimel, MD, and Mansoor R. Mirza, MD, on Endometrial Cancer: Patient-Reported Outcomes With Dostarlimab, Carboplatin, and Paclitaxel

Bobbie J. Rimel, MD, of Cedars-Sinai Medical Center, and Mansoor R. Mirza, MD, of Denmark’s Rigshospitalet and Copenhagen University Hospital, discuss new findings on dostarlimab-gxly plus carboplatin/paclitaxel, which improved progression-free survival while maintaining health-related quality of life, further supporting its use as a standard of care in primary advanced or recurrent endometrial cancer (Abstract 5504).

Advertisement

Advertisement




Advertisement