Kyle Doherty

A database analysis presented ahead of the 2022 ASCO Annual Meeting showed an association between increased spending on state public welfare programs and a higher 5-year overall survival (OS) rate among Black patients. The increased investment in social spending was also shown to reduce racial disparities in survival between non-Hispanic Black and white patients with several tumor types, including bladder cancer. 

The study, which involved a review of data form the National Cancer Institute’s Surveillance Epidemiology and End Results (SEER) cancer database, showed that 5-year OS was 10.8% lower among Black patients compared with Whites. However, investigators found that 5-year OS was higher for Black patients in states with greater welfare spending.

The results showed that there was a 4.55% reduction of the 5-year OS disparity in non-Hispanic Black patients compared with white patients per every 10% increase in spending. Investigators noted that the results were similar after accounting for state Medicaid eligibility limits and after excluding data related to Medicaid expansions.

“These data are thought provoking, but they are certainly not the end,” lead author Justin M. Barnes, MD, a radiation oncologist at Washington University of Medicine in St. Louis, Missouri, said during a press briefing. “I see these data as a proof-of-concept project, some sort of public welfare investment seems to be helping improve oncologic outcomes for some of our most socioeconomically at-risk patients.”

Among patients with breast cancer, increased public welfare spending led to a 6.15% survival increase for Black patients and a 39% closing of the disparity with white patients. Patients with cervical (11.9% and 46%), colorectal (4.42% and 48%), head and neck (9.41% and 38%), liver (7.02% and 49%), ovarian (8.95% and 41%), bladder (8.18% and 44%), and uterine cancers (14.1% and 40%) also experienced a survival increase and a lessened disparity as a result of increased spending.

Past study results have highlighted associations between cancer outcomes and social determinants of health, such as financial stability, education, place of residence, and insurance status. Additionally, research has shown that racial disparities in cancer outcomes are probably related to systemic racism that has led to adverse conditions for Black Americans and other patients of color.

Barnes and colleagues analyzed data on more than 2.9 million adult patients with newly diagnosed cancers collected in the SEER database between 2007 and 2016. State annual spending data was obtained from the United States Census Bureau and included the percentage of total public welfare spending. The primary end point of the study was 5-year OS.

Investigators performed data analysis using cluster-robust regression to account for within-state correlations. Covariates consisted of state public welfare spending, age, race/ethnicity, sex, metropolitan residence, county-level income and education, insurance, state-level poverty, state, cancer site/type, and stage at diagnosis.

“This study underscores the critical role that state social welfare spending, including Medicaid expansion, plays in reducing cancer outcome disparities,” ASCO Chief Medical Officer and Executive Vice President Julie R. Gralow, MD, the 2021 Giants of Cancer Care® award winner in the community outreach/cancer policy category, said in a news release. “State-funded programs can reduce barriers to accessing cancer care and impact survival.”

Barnes JM, Johnston KJ, Osazuwa-Peters N. State public welfare spending and racial/ethnic disparities in overall survival among adults with cancer. Presented at: 2022 ASCO Annual Meeting; June 3-7, 2022; Chicago, IL. Abstract 6509.

A study examining the association between Medicaid and other social services spending on racial and ethnic disparities and overall survival for newly diagnosed patients with cancer. News release. ASCO. May 26, 2022. Accessed May 26, 2022.

Articles

Among patients with bladder cancer, increased public welfare spending led to an 8.18% survival increase for Black patients and a 44% closing of the disparity gap with white patients.

Social spending increase linked to better survival outcomes for black patients with cancer

Phase 1 study findings presented at the 2022 AUA Annual Meeting showed that IS-002, an investigational, near-infrared, PSMA-targeting fluorophore, enhanced intraoperative cancer visualization during robotic prostatectomy.

IS-002 in combination with fluorescence-guided surgery (FGS) detected residual adenocarcinoma in the resection bed of 9 of 24 (37.5%) patients with high-risk prostate cancer that was not identified using conventional white light imaging. This included invasions in the neurovascular bundle (n = 4), bladder neck (n = 2), seminal vesicles (n = 1), levator ani (n = 1), and Denonvilliers’ fascia (n = 1).

Use of IS-002 plus FGS also intraoperatively detected regional nodal metastases in 12.5% of patients. Additionally, ex vivo imaging confirmed IS-002 prostate tumor signal in 95.8% of patients. Study authors noted that the study treatment provided excellent tumor discrimination over background.

Investigators found that IS-002 plus FGS was well tolerated. Among patients who received IS-002 experienced only grade 1 adverse effects (AEs), consisting of green urine/feces (n = 23) and bruising/rash (n = 2).

In the phase 1 dose-escalation study (NCT04574401), patients received intravenous IS-002 24 hours prior to surgery. IS-002 was given at 4 dose levels (25 µg/kg, 50 µg/kg, 100 µg/kg, and 150 µg/kg) with 6 patients in each group. Surgeons performed robotic prostatectomy using the da Vinci X/Xi Surgical System and Sensitive Firefly Fluorescence Imaging. The pharmacokinetic and safety profile of IS-002 were assessed over a 14-day period.

The primary end point of the trial was treatment-emergent AEs assessed by Common Terminology Criteria for Adverse Events v5.0. Secondary end points included IS-002 maximum plasma concentration, IS-002 half-life, IS-002 clearance, and IS-002 area under the plasma concentration vs time curve. The number of lymph nodes with IS-002 fluorescent signal that contain metastatic disease and the number of patients with above-background IS-002 fluorescent signal observed on the prostate surface were also included as exploratory end points.

To be eligible for the trial, patients needed to be treatment-naïve and between the ages of 18 and 75. Patients also needed to have a Cancer of the Prostate Risk Assessment score greater than 6, T3 a or b disease upon imaging, or regional lymphadenopathy suspicious for nodal metastases.

Patients with active hepatitis B virus or hepatitis C virus infection, a known history of bone metastasis, or a known history of acute or chronic liver or kidney disease were not eligible for the trial. Patients who were currently participating in another study or received study therapy within the past 6 months were also not permitted.

“Based on the very encouraging results of this phase 1 study, a randomized phase 2 study is planned,” lead author Hao Nguyen, MD, PhD, and colleagues wrote in conclusion. Nguyen is a urologic oncologist at the UCSF Helen Diller Family Comprehensive Cancer Center.

Nguyen H, Antaris A, Van den Berg N, et al. Results of the Phase 1 safety and efficacy prostate specific membrane antigen (PSMA) targeting fluorophore for image guided surgery in patients undergoing robotic prostatectomy. Paper presented at: 2022 American Urological Association Annual Meeting; May 13-16. New Orleans, LA. Abstract PD54-11.

A phase 1 study of IS-002 injection in patients undergoing robotic prostatectomy. ClinicalTrials.gov. Updated October 22, 2021. Accessed May 16, 2022. clinicaltrials.gov/ct2/show/NCT04574401

IS-002, an investigational, near-infrared, PSMA-targeting fluorophore, enhanced intraoperative cancer visualization during robotic prostatectomy.

Novel PSMA-targeting fluorescent dye facilitates image-guided robotic prostatectomy

Adjuvant nivolumab (Opdivo) continued to demonstrate a clinically meaningful disease-free survival (DFS) benefit in patients with high-risk, muscle-invasive urothelial carcinoma, according to extended follow-up from the phase 3 CheckMate 274 trial.

Data shared during the 2022 AUA Annual meeting showed that with an additional 5 months of follow-up, patients in the intention-to-treat (ITT) population who received nivolumab (n = 353) experienced a median DFS of 22.0 months (95% CI, 17.7-36.9) compared with 10.9 months (95% CI, 8.3-14.0) among the 356 patients who received placebo (HR, 0.70; 95% CI, 0.57-0.85). The 12-month DFS rates were 63.5% vs 46.9%, respectively.

The DFS benefit was even more pronounced in patients with PD-L1 expression of at least 1%; the median DFS was not reached (NR; 95% CI, 22.1-not estimable [NE]) in the nivolumab cohort (n = 140) vs 8.4 months (95% CI, 5.6-20.0) in the placebo cohort (n = 142; HR, 0.53; 95% CI, 0.38-0.75).1 The 12-month DFS rates were 67.6% vs 46.3%, respectively.

In terms of non–urothelial tract recurrence-free survival (NUTRFS), the median was 26.0 months (95% CI, 19.5-41.1) in the nivolumab arm compared vs 13.7 months (95% CI, 8.4-20.0), in the placebo arm (HR 0.71; 95% CI, 0.58-0.88), with 46.7% vs 55.9% of patients experiencing events, respectively. Among patients with a PD-L1 expression of at least 1%, the median NUTRFS was NR (95% CI, 25.8-NE) vs 10.8 months (95% CI, 5.7-20.7), respectively (HR, 0.54; 95% CI, 0.39-0.77).

Investigators also observed a benefit indistant metastasis-free survival (DMFS) among patients who received nivolumab compared with placebo; the median DMFS was 41.1 months (95% CI, 26.0-NE) vs 29.2 months (95% CI, 15.2-NE), respectively (HR, 0.73; 95% CI, 0.58-0.92). Patients with PD-L1 at or over 1% had a median DMFS of NR (95% CI, 26.0-NE) when treated with nivolumab compared with 20.7 months (95% CI, 10.8-NE) when treated with placebo (HR, 0.60; 95% CI, 0.41-0.88).

DFS benefits were also seen with nivolumab treatment across most of the subgroups analyzed, including age, sex, ECOG performance status, nodal status, and use of prior cisplatin-based chemotherapy.

“These results support adjuvant nivolumab as a standard of care for high-risk [patient with] muscle-invasive urothelial carcinoma after radical surgery,” Matthew Galsky, MD, and colleagues wrote. Galsky is a professor medicine (hematology and medical Oncology), director of genitourinary medical oncology at the Icahn School of Medicine at Mount Sinai, in New York, New York. He also serves at the codirector of the Center of Excellence for Bladder Cancer and associate director for translational research at The Tisch Cancer Institute.

Adjuvant nivolumab monotherapy was previously approved on August 19, 2021, for patients with urothelial carcinoma who are at high risk of recurrence after undergoing radical resection based on findings from CheckMate 274.

The double-blind CheckMate 274 trial randomly assigned patients 1:1 to receive either nivolumab 240 mg twice weekly or placebo for a total adjuvant treatment time of 1 year or until disease recurrence or discontinuation. Eligible patients underwent radical surgery within 120 days before randomization with or without neoadjuvant cisplatin therapy. Patients were stratified by PD-L1 status, pathological nodal status, and prior chemotherapy use.

The coprimary end points of the study were DFS in the entire population and among patients with PD-L1 expression of 1% or greater. Secondary end points included NUTRFS, overall survival, and disease-specific survival. DMFS was also included as an exploratory end point.

The baseline patient characteristics in the trial were well balanced between the 2 arms. The mean age was 65.3 years (range, 30-92) and 65.9 years (range, 42-88) in the nivolumab and placebo arms, respectively. Most patients in both cohorts were males (75.1% vs 77.2%), white (74.8% vs 76.4%), and had an ECOG performance status of 0 (63.5% vs 62.1%).

Regarding safety, 351 patients in the experimental arm and 348 in the placebo arm were evaluable. Adverse effects (AEs) of any cause and any grade occurred in 98.9% and 95.4% of patients, respectively. Common AEs of any grade in the nivolumab arm included pruritus (23.1%), fatigue (17.4%), and diarrhea (16.8%). In the placebo arm, the most common AEs of any grade were fatigue (12.1%), pruritus (11.5%), and diarrhea (10.9%).

Two patients in the nivolumab group died, with both deaths attributed to pneumonitis. Treatment-related AEs of any grade led to discontinuation in 12.8% of patients in the nivolumab arm compared with 2.0% of patients in the placebo arm. The most common treatment-related AEs in the investigative arm were pneumonitis (1.7%), rash (1.1%), and colitis (0.9%).

1. Galsky M, Witjes JA, Gschwend JE, et al. Disease-free survival with longer follow-up from the CheckMate 274 trial of adjuvant nivolumab in patients after surgery for high-risk muscle-invasive urothelial carcinoma. 

. 2022;207(suppl 5):e183. doi:10.1097/JU.0000000000002536.01

2. FDA approves nivolumab for adjuvant treatment of urothelial carcinoma. News release. FDA. Updated February 2, 2022. Accessed May 13, 2022. bit.ly/39nf4Fq

3. Bajorin DF, Witjies JA, Gschwend JE, et al. Adjuvant nivolumab versus placebo in muscle-invasive urothelial carcinoma

. 2021;384(22):2102-2114. doi:10.1056/NEJMoa2034442

Adjuvant nivolumab continued to demonstrate a clinically meaningful disease-free survival benefit in patients with high-risk, muscle-invasive urothelial carcinoma, according to extended follow-up from the phase 3 CheckMate 274 trial.

Adjuvant nivolumab benefit in urothelial carcinoma sustained with longer follow-up

Immunotherapy and targeted therapies have revolutionized the treatment paradigm in metastatic urothelial cancer, with more advances to come on the horizon, explained 

 Interdisciplinary Prostate Cancer Congress® and Other Genitourinary Malignancies.

Petrylak, a professor of Medical Oncology and Urology at Yale Cancer Center, said currently available options for patients with metastatic urothelial carcinoma include 2 immune checkpoint inhibitors approved for the frontline treatment of patients who are ineligible for cisplatin: atezolizumab (Tecentriq) and pembrolizumab (Keytruda). Three others are approved for patients who have previously received platinum-based chemotherapy: nivolumab (Opdivo), avelumab (Bavencio), and pembrolizumab.

“Atezolizumab and durvalumab [Imfinzi] have been removed from the list [of second-line treatment options] voluntarily,” Petrylak said, citing the 2021 withdrawn indications by Roche and AstraZeneca, respectively. The indication for atezolizumab was withdrawn after failing to show a marked improvement over standard-of-care chemotherapy missing the primary end point of the IMvigor211 trial (NCT02302807).

 “Durvalumab also did not do well in randomized trials compared with chemotherapy,” Petrylak said, citing data from the phase 3 DANUBE trial (NCT02516241).

In discussing treatment determinations, Petrylak noted that for patients with low PD-L1 expression had decreased survival benefits compared with patients treated with chemotherapy in the monotherapy arms of the phase 3 KEYNOTE-361 (NCT02853305) and phase 3 IMVIGOR-130 (NCT02807636) trials. Patients with low PD-L1 expression should be treated with carboplatin-based chemotherapy and those with high PD-L1 expressions should receive either pembrolizumab or atezolizumab, Petrylak contended.

Following treatment with frontline chemotherapy—either cisplatin or carboplatin in combination with gemcitabine—Petrylak noted that a switch maintenance approach with avelumab is the preferred treatment choice. Data from the phase 3 JAVELIN Bladder 100 study (NCT02603432) showed that avelumab plus best supportive care (BSC) administered in the maintenance setting elicited a favorable response vs BSC alone.

“I call this, ‘line 1.5,’ which is maintenance therapy after initial chemotherapy,” Petrylak said. Investigators randomly assigned 350 to each arm; 189 patients in the avelumab arm had PD-L1–positive disease compared with 169 patients in the BSC arm.

Among patients who received avelumab in the PD-L1-positive population, the median OS was not estimable (NE; 95% CI, 20.3-NE) compared with 17.1 months (95% CI, 13.5-23.7) in patients who received BSC alone (HR, 0.56; 95% CI, 0.40-0.79; 

 < .001). Unlike in the first-line setting, In the overall population, patients treated in the avelumab arm had a median progression-free survival (PFS) of 3.7 months (95% CI, 3.5-5.5) compared with 2.0 months (95% CI, 1.9-2.7) in the BSC alone arm (HR, 0.62; 95% CI, 0.52-0.75; 

 < .001). The 12-month PFS rates were 30% and 13%, respectively.

“We have a more pronounced difference [in survival] in the PD-L1-positive population,” Petrylak noted. “Why are we seeing this difference with maintenance therapy vs [treatment with] upfront checkpoint inhibitors, where we haven’t seen combination therapy show an improvement in survival? It may be related to the changes in the tumor environment or the extracellular matrix that may be induced by chemotherapy.”

Despite the success with avelumab in this setting, results from a randomized phase 2 trial (NCT02500121) showed that pembrolizumab did not provide the same survival benefit as maintenance therapy. Although patients with metastatic urothelial carcinoma treated with pembrolizumab had a higher median PFS than those who received placebo (5.4 months vs 3.0 months, respectively), the OS benefit did not significantly improve (22 months vs 18.7 months, respectively).

 mutations have become a target of interest in metastatic urothelial carcinoma, as overexpression has been implicated in bladder cancer, Petrylak said. He noted that 

 expression is detected in up to 20% of patients with metastatic urothelial carcinoma. In 2019, the FDA granted accelerated approval to the FGFR inhibitor erdafitinib (Balversa) for the treatment of patients with metastatic bladder cancer harboring an 

 alteration that has progressed during or after chemotherapy.

In the phase 2 BLC2001 study (NCT02365597), patients with metastatic urothelial carcinoma who progressed after chemotherapy or were cisplatin-ineligible treated with erdafitinib (n= 99) achieved an overall response rate (ORR) of 40.4% (95% CI, 30.7%-50.1%). Those who had received prior immunotherapy (n = 22) had an ORR of 59%. Patients treated with erdafitinib also saw survival benefits: the median PFS was 5.5 months (95% CI, 4.2-6.0) and the median OS was 13.8 months (95% CI, 9.8-NE).

“[These results] are pretty impressive,” Petrylak said. “The drug has toxicities, and they must be managed. [However], there were no grade 4 or 5 treatment-related adverse events.”

Other investigational FGFR inhibitors are being evaluated in metastatic urothelial carcinoma, including infigratinib (Truseltiq) in a phase 1 trial (NCT01004224) and rogaratinib in the phase 2/3 FORT trial (NCT03410693).

In available data from the phase 1 trial of infigratinib, the agent showed promising activity as a monotherapy. Patients who received infigratinib as a frontline therapy (n = 13) had an ORR of 30.8% (95% CI, 9.1%-61.4%) and patients who received it in the second line (n = 54) had an ORR of 42.6% (95% CI, 29.2%-56.8%). Median PFS was 3.65 months (95% CI, 0.95-7.43) among the treatment-naïve population and 3.75 months (95% CI, 3.09-5.42) for those treated in the second line.

Moving away from immunotherapy in later lines of therapy, Petrylak turned his attention to the antibody-drug conjugates (ADCs). Enfortumab vedotin-ejfv (Padcev) is an ADC engineered to target nectin-4, which is expressed in approximately 90% of urothelial cancer cells. Investigators assessed enfortumab vedotin in metastatic urothelial carcinoma as a monotherapy in the phase 2 EV-201 trial (NCT03219333) and in combination with pembrolizumab in the phase 1/2 EV-103 trial (NCT03288545).

In EV-201, patients who received enfortumab vedotin had an ORR of 44% (n =110; 95% CI, 35.1%-53.2%), including 12% achieving complete responses (CRs). The median PFS was 5.8 months (95% CI 4.9-7.5), and the median OS was 11.7 months (95% CI, 9.1-not reached [NR]). Petrylak noted that responses were observed across all subgroups, including patients with primary tumor sites in the upper tract (ORR, 61%), with liver metastasis (ORR, 48%), and those who did not respond to prior PD-1/PD-L1 inhibitors (ORR, 48%).

In EV-103, patients treated with enfortumab vedotin plus pembrolizumab (n = 45) achieved an ORR of 73.3% (95% CI, 58.1%-85.4%), including 15.6% of patients having a CR, regardless of PD-L1 expression level. The median OS was 26.1 months (95% CI, 15.7 -NR) at a median follow-up of 24.9 months.

“This is probably the most impressive data that we’ve seen with any combination therapy,” Petrylak said. “These [data] need further confirmation; there are randomized trials ongoing looking at this combination of neoadjuvant therapy, as well as this combination up front compared with cisplatin- or carboplatin-based chemotherapy.”

Subsequently, data from the phase 3 EV-301 trial (NCT03474107) supported the FDA approval of enfortumab vedotin as second-line treatment of patients with metastatic urothelial cancer.

 The median OS for those who received enfortumab vedotin (n = 310) was 12.88 months (95% CI, 10.58-15.21) compared with 8.97 months (95% CI, 8.05-10.74) for those who received chemotherapy (n = 307; HR, 0.70; 95% CI, 0.56-0.89; 

 = .000412). The 6- and 12-month OS rates for enfortumab vedotin were 77.9% (95% CI, 72.74%-82.25%) and 51.5% (95% CI, 44.63%-58.03%), respectively. Among those who received chemotherapy, the 6- and 12-month OS rates were 69.5% (95% CI, 63.85%-74.38%) and 39.2% (95% CI, 32.60%-45.64%).

Further, in the response evaluable population, patients who received enfortumab vedotin (n = 288) had an ORR of 40.6% (95% CI, 34.90%-46.54%) compared with 17.9% (95% CI, 13.71%-22.76%) among those who received chemotherapy (n = 296). The disease control rates were 71.9% (95% CI, 66.30%-76.99%) and 53.4% (95% CI, 47.52%-59.17%), respectively.

Another ADC, sacituzumab govitecan-hziy (Trodelvy), displayed efficacy as a second-line treatment option for patients with metastatic urothelial carcinoma in the phase 2 TROPHY U-01 trial (NCT03547973). “Sacituzumab govitecan has accelerated approval in patients who have received prior therapies,” Petrylak said.

Patients who progressed after prior chemotherapy and anti-PD-1/PD-L1 therapies treated with sacituzumab govitecan (n = 113) achieved an ORR of 27.4% (95% CI, 19.5%-36.6%), including 6 CRs. The median PFS was 5.4 months (95% CI, 3.5-7.2) and the median OS was 10.9 months (95% CI, 9.0-13.8).

Petrylak concluded by stating that future directions for the field include continued evaluation of combination checkpoint inhibition with targeted therapy.

1. Petrylak DP. Metastatic bladder cancer: immunologic and targeted approaches. Presented at New York GU 14th Annual Interdisciplinary Prostate Cancer Congress® and Other Genitourinary Malignancies; March 12-13, 2021; virtual. Accessed March 12, 2021.

2. Roche provides update on Tecentriq US indication in prior-platinum treated metastatic bladder cancer. News release. Roche. March 8, 2021. Accessed March 11, 2022. https://www.roche.com/media/releases/med-cor-2021-03-08.htm

3. Voluntary withdrawal of Imfinzi indication in advanced bladder cancer in the US. News release. AstraZeneca. Published February 22, 2021. Accessed March 11, 2022. https://www.astrazeneca.com/content/astraz/media-centre/press-releases/2021/voluntary-withdrawal-imfinzi-us-bladder-indication.html

4. Powles T, Park SH, Voog et al. Maintenance avelumab + best supportive care (BSC) versus BSC alone after platinum-based first-line (1L) chemotherapy in advanced urothelial carcinoma (UC): JAVELIN Bladder 100 phase III interim analysis. 

. 2020;38(suppl 18):LBA21. doi:10.1200/JCO.2020.38.18_suppl.LBA1

5. Galsky MD, Mortazavi A, Milowsky MI, et al. Randomized double-blind phase ii study of maintenance pembrolizumab versus placebo after first-line chemotherapy in patients with metastatic urothelial cancer. 

. 2020;38(16):1797-1806. doi:10.1200/JCO.19.03091

6. Balversa. Prescribing Information. Janssen Pharmaceuticals; 2019. Accessed March 11, 2022. bit.ly/2X67iEm

7. Siefker-Radtke AO, Necchi A, Park SH, et al. First results from the primary analysis population of the phase 2 study of erdafitinib (ERDA; JNJ-42756493) in patients (pts) with metastatic or unresectable urothelial carcinoma (mUC) and FGFR alterations (FGFRalt). 

. 2018;36(suppl 15):4503. doi:10.1200/JCO.2018.36.15_suppl.4503

8. Lyou Y, Grivas P, Rosenberg JE, et al. Infigratinib and treatment response in advanced/unresectable or metastatic urothelial carcinoma in first-line and later-line treatment settings. 

. 2020;38(suppl 15):5038. doi:10.1200/JCO.2020.38.15_suppl.5038

9. Balar AV, McGregor A, Rosenber JE, et al. EV-201 cohort 2: enfortumab vedotin in cisplatin-ineligible patients with locally advanced or metastatic urothelial cancer who received prior PD-1/PD-L1 inhibitors. 

. 2021;39(suppl 6):394. doi:10.1200/JCO.2021.39.6_suppl.394

10. Rosenberg JE, Flaig TW, Friedlander TW, et al. Study EV-103: preliminary durability results of enfortumab vedotin plus pembrolizumab for locally advanced or metastatic urothelial carcinoma. 

. 2020;38(suppl 6):441-441. doi:10.1200/JCO.2020.38.6_suppl.441

11. FDA grants regular approval to enfortumab vedotin-ejfv for locally advanced or metastatic urothelial cancer. FDA. July 9, 2021. Accessed March 11, 2022. bit.ly/3i1zoNv

12. Powles T, Rosenberg JE, Sonpavde GP, et al. Enfortumab vedotin in previously treated advanced urothelial carcinoma. 

. 2021;384(12):1125-1135. doi:10.1056/NEJMoa2035807

13. Tagawa ST, Balar AV, Petrylak DP, et al. TROPHY-U-01: a phase II open-label study of sacituzumab govitecan in patients with metastatic urothelial carcinoma progressing after platinum-based chemotherapy and checkpoint inhibitors. 

. 2021;39(22):2474-2485. doi:10.1200/JCO.20.03489

In discussing treatment determinations, Petrylak noted that for patients with low PD-L1 expression had decreased survival benefits compared with patients treated with chemotherapy in the monotherapy arms of the phase 3 KEYNOTE-361 (NCT02853305) and phase 3 IMVIGOR-130 (NCT02807636) trials.

Kyle Doherty

Articles

Social spending increase linked to better survival outcomes for black patients with cancer

Novel PSMA-targeting fluorescent dye facilitates image-guided robotic prostatectomy

Adjuvant nivolumab benefit in urothelial carcinoma sustained with longer follow-up

Dr. Petrylak highlights the latest advances in metastatic urothelial cancer