GU Cancers Symposium

Clinical benefit with olaparib plus abiraterone was observed in patients with BRCA2, ATM, and CDK12 mutations, which were the most prevalent single-gene HRR mutations across all patients treated.

"Certainly germline and somatic is recommended for all mCRPC patients to detect HR gene mutations, and consider options for PARP inhibitors,” says Neal Shore, MD, FACS.

Beyond being highly predictive of future recurrence, uMRD was also shown to enable quantitative evaluation of molecular response to nadofaragene.

“We're really looking at a situation where most of the HRR testing is happening when patients have already exhausted all other standard options,” says Daniel J. George, MD.

"The key end points were observed response rate in the overall cohort, progression-free and overall survival from EV start in the overall cohort, and as an exploratory end point, overall survival from platinum-based chemotherapy start in the overall cohort," says Amanda Nizam, MD.

Ten-year follow-up data from the GETUG-AFU 18 trial showed that in patients with high-risk prostate cancer, survival outcomes were improved when combining a higher dose of radiation therapy with long-term use of androgen deprivation therapy.

“HRR testing in patients before or at the time of mCRPC [diagnosis] would allow for olaparib therapy earlier in the disease course and potentially greater clinical benefit," wrote Daniel J. George, MD, and colleagues.

The median PFS was 39 months (95% CI, 22-not reached [NR]) in arm 3 compared with 8.4 months (95% CI, 2.9-17.0) in arm 1 and 14 months (95% CI, 8.4-20.0) in arm 2.

"What ARASTEP is asking is how effective of a biomarker is PSMA PET/CT?" says Alexander M. Chehrazi-Raffle, MD.

Patients in the CONTACT-02 trial had received exactly one prior novel hormonal therapy (abiraterone acetate, apalutamide, darolutamide, or enzalutamide) to treat their prostate cancer.

Drug-related hematological treatment-emergent adverse events were proportionately similar between the EBRT cohort and the those who did not receive EBRT to the bone.

Regarding safety, the investigators did not observe any grade 3 or 4 adverse events during the study.

"What we found is that there was rapid adoption and uptake of PSMA PET almost immediately after these agents were first approved in the United States," says Michael S. Leapman, MD, MHS.

Compared with placebo, darolutamide was associated with a numerically lower rate of hospitalizations when combined with androgen-deprivation therapy and docetaxel to treat patients with metastatic hormone-sensitive prostate cancer.

“We hypothesized that the combination of guadecitabine plus durvalumab would increase T lymphocyte infiltration and result in antitumor activity,” said lead study author Yousef Zakharia, MD.

Combination therapy with the novel agent BXCL701 and pembrolizumab showed strong clinical activity in in patients with platinum-resistant small cell neuroendocrine carcinoma metastatic castration-resistant prostate cancer.

“One of the key challenges in the refractory renal cell population is identifying mechanisms of resistance to immune checkpoint inhibitors, and really delving in and figuring out how to target those mechanisms of resistance,” says Zhang.

Part of Shore’s recommendations include 15 to 30 minutes of exercise daily, consisting of both a cardio component and some level of cross resistance for muscle development.

"These findings may directly inform clinical care, such as providing diet recommendations for managing health, and potentially offer other positive health benefits for preventing numerous chronic diseases,” said Bradley Alexander McGregor, MD.

"We also saw in the high-risk group that patients who identified as Black were much more likely to not receive treatment than their White counterparts," says Madison Novosel, BA.

“What we saw in phase 3 studies and what we've seen in earlier studies—early phase 1/2 studies—is really a paucity of cognitive impairment and a paucity of depression with darolutamide that we've seen across the class of androgen receptor signaling inhibitors,” says Neal Shore, MD.

"The Medicaid and uninsured patients had significantly lower odds of getting treatment than those who [have] private insurance," says Madison Novosel, BA.

Laura Bukavina, MD, and Kyle Rose, MD, discuss some of the notable abstracts from the 2023 ASCO GU conference.

Neal Shore, MD, discusses results from the open-label rollover study from the phase 3 ARAMIS trial, which he presented at the 2023 Genitourinary Cancers Symposium.

“The field of germline testing for prostate cancer has expanded significantly; it's really become central in terms of thinking about treatment for men with metastatic prostate cancer,” says Veda Giri, MD.

The secondary analysis Hussain presented at the GU Symposium showed that the risk of death was reduced by 32% across all volume and subgroups in men with mHSPC treated with the darolutamide-based triplet regimen.

"In our lab, we found that when you gave it to the mice model of bladder cancer, the tumors go away, and they're infiltrated with immune cells," says Joshua J. Meeks, MD, PhD.

"While the data are still early, EG-70's safety profile and efficacy are well on their way towards establishing a new benchmark for monotherapy treatment of high-risk NMIBC with BCG-unresponsive carcinoma in situ,” said lead study author Gary Steinberg MD.

"The model that we developed was able to behave as accurately as clinical models that were previously validated," says Nour Abdallah, MD.

"Darolutamide achieved the primary endpoint. Easily 100% of the patients had a PSA decrease above 90%," says Bertrand F. Tombal, MD, PhD.