GU Cancers Symposium

“The effect size for adjuvant nivolumab versus placebo across primary, secondary, and exploratory endpoints is all remarkably stable,” says Matthew D. Galsky, MD.

Treatment with nivolumab in patients with high-risk muscle-invasive urothelial carcinoma continued to improve survival, supporting its use as a standard of following radical resection.

In cohort B of the phase 2 Keynote-057 trial, pembrolizumab led to antitumor activity in patients with BCG-unresponsive, papillary high-risk non–muscle-invasive bladder cancer.

Treatment with rucaparib reduced risk of imaging-based progression or death by half in men with BRCA-altered metastatic castration-resistant prostate cancer.

Of note, 55% of patients received a full course (6 injections) of radium-223 injections, and 67% received 5 of the 6 injections.

"The median survival of the combination arm was 16.1 months versus 13.4 months in the standard chemo arm," says Enrique Grande, MD.

“These data support further evaluation of sacituzumab govitecan—alone or in combination—in patients with metastatic urothelial carcinoma who progressed after prior CPI therapy,” says Daniel P. Petrylak, MD.

The ORR for patients was 47%. Of note, ORRs were higher in patients with specific alterations compared with wild type including ERBB2 (67% vs. 44%, respectively; P = .05) and TSC1 (68% vs. 25%; P = .04).

The combination use of niraparib plus abiraterone and prednisone continued to improve outcomes in patients with metastatic, castration-resistant prostate cancer and HRR gene alterations.

In the the phase 2 HCRN GU 16-257 trial, 33 patients with muscle-invasive bladder cancer were eligible to forego cystectomy and continue 240-mg maintenance nivolumab monotherapy every 2 weeks for 8 cycles followed by surveillance.

“There are a number of trials that we're interested in to develop potentially combining chemotherapy and neoadjuvant immunotherapy,” says Joshua J. Meeks, MD, PhD.

"The MMAI model had significantly improved accuracy and prognostication to discriminate which patients would develop distant metastasis or die from prostate cancer," says Daniel E. Spratt, MD.

“This represents one of the largest reported in the phase 3 trials in first-line mCRPC,” says investigator Noel W. Clarke, MBBS, FRCS, ChM.

"We found that if the patient has normal IsoPSA, he has only 1% of risk of developing clinically significant prostate cancer in a median follow-up time of 18 months," says Nour Abdallah, MD.

Data showed that treatment with talazoparib plus enzalutamide resulted in a 37% reduction in the risk of progression or death as assessed by blinded independent central review.

By the data cut-off date of January 31, 2023, investigators reported that 30% of patients with nonmetastatic castration-resistant prostate cancer had received darolutamide for at least 4 years, and 24% of were still receiving the agent.

Results of the ARASENS trial (NCT02799602) demonstrated that darolutamide plus ADT and docetaxel prolonged overall survival regardless of disease volume or risk.

Investigators compared 3 second-generation androgen receptor inhibitors to determine real-world utilization of the drugs and examine the incidence of adverse events.

“Obviously, patients benefit [from this regimen]. Not only can they enjoy longer life, but also their cancer is pretty much under control for a longer time, which is great,” says Karim Fizazi, MD, PhD

“I think results from this study introduce a new standard of care for patients with metastatic hormone-sensitive prostate cancer, where we clearly need to do better than what we're doing today, since the sequence of therapy seems to be less effective than hitting them hard upfront,” says Fred Saad, MD, FRCS.

“If you're going to be embarking upon triplet based therapy, as Arasens has now clearly demonstrated the potential advantage, having really healthy and productive and efficient conversations with your integrated cancer care team is paramount,” says Neal D. Shore, MD, FACS.

Investigators of a recent study presented at the 2022 ASCO Genitourinary Cancers Symposium reported favorable outcomes of pembrolizumab in patients with renal cell carcinoma at 30-month follow up.

In this interview, lead author Benjamin Lowentritt, MD, FACS, discusses why the findings of the study, "Attainment of early, deep prostate-specific antigen response in metastatic castration-sensitive prostate cancer: A comparison of patients initiated on apalutamide or enzalutamide," are so important in future counseling for mCSPC.

Long-term follow-up from the CheckMate 9ER trial continued to show that first-line treatment with nivolumab plus cabozantinib was associated with a health-related quality-of-life benefit over treatment with sunitinib in patients with advanced renal cell carcinoma .

Efficacy and safety data from the final analysis of the retrospective CaboCHECK trial support the use of cabozantinib in patients with advanced or metastatic renal cell carcinoma after progression on immunotherapy.

Despite missing the primary end point, avelumab did demonstrate notable clinical activity and a favorable safety profile in the phase 2 ARIES trial.

“I think the notable finding is the fact that the overall detection rate is very high, even at low PSA levels,” says David M. Schuster, MD, FACR.

“I do think that this helps inform how to choose an agent for this specific stage of the disease,” says Benjamin Lowentritt, MD, FACS.

“I think this data are very compelling,” says Neal D. Shore, MD, FACS.

Treatment with tivozanib was associated with a fivefold increased likelihood of experiencing long-term progression-free survival compared to treatment with sorafenib.