GENITOURINARY CANCERS

During a Targeted Oncology Case-Based Peer Perspectives Roundtable, two Mayo Clinic experts, Alan H. Bryce, MD, and Roxana S. Dronca, MD, discuss treatment options for a 66-year-old woman with urothelial carcinoma.

After decades of dormancy, the therapeutic landscape of locally advanced/metastatic urothelial cancer underwent a paradigm shift—with multiple regulatory approvals of immune checkpoint inhibitors as second-line treatment—leading to changes in guideline-recommended management of patients in this setting.

Anthony A. Meluch, MD, medical oncologist, Tennessee Oncology, discussed treatment options for high-risk adenocarcinoma of the prostate based on the case of a 75-year-old patient during a Targeted Oncology Case-Based Peer Perspectives event.

Experts in oncology and hematology review some of the most impactful FDA approvals from 2020 in lung, breast, blood, gastrointestinal, and genitourinary cancers.

Michael A. Carducci, MD, provided recommendations for treatment of a 75-year-old man with castrastion-resistant prostate cancer.

Petros Grivas, MD, PhD, discusses the phase 3 KEYNOTE-045 trial and the association between gene expression signatures and pembrolizumab in patients with advanced urothelial cancer.

Durable responses were shown with the investigational agent UGN-102 as treatment of patients with low-grade intermediate-risk non-muscle invasive bladder cancer, according to final results of the phase 2b OPTIMA II study .

In genitourinary cancers, presentation of subgroup analysis data from large randomized clinical trials demonstrated findings that will change practice for oncologists who treat patients with prostate cancer, bladder cancer, and renal cell carcinoma.

Neeraj Agarwal, MD, discusses the efficacy of nivolumab and cabozantinib versus sunitinib in patients with previously untreated advanced or metastatic renal cell carcinoma in the phase 3 CheckMate-9ER trial.

Bradley McGregor, MD, discusses the CheckMate-9ER trial of nivolumab plus cabozantinib versus sunitinib in patients with previously untreated advanced or metastatic renal cell carcinoma.

Biomarkers of immune activity were linked with overall survival benefit to frontline maintenance avelumab in patients with advanced urothelial cancer, according to data presented at the ESMO Virtual Congress 2020 from an exploratory analysis of the phase 3 JAVELIN Bladder 100 trial.

Final results from cohort 1 of the phase 3 TROPHY-U-01 trial reported continued significant activity with sacituzumab govitecan-hziy as treatment of patients with metastatic urothelial carcinoma who progressed on both platinum-based chemotherapy and checkpoint inhibition.

Stratified multivariate analysis as well as efficacy from multiple treatment time points confirmed the benefit of cabazitaxel over abiraterone acetate or enzalutamide as a standard treatment in men with metastatic castration-resistant prostate cancer who were previously treated with docetaxel and either of those 2 androgen receptor-targeted agents, according to results presented during the 2020 American Society of Clinical Oncology Virtual Scientific Program.

"Irrespective of the PD-L1 status, there were no trends in favor of atezolizumab in both arms."

Patients with urothelial carcinoma who progress after platinum-containing chemotherapy may receive benefit with the combination regimen of cabozantinib and atezolizumab, according to new data from the COSMIC-021 study.

"These interim data demonstrate that primary chemoablation of low-grade intermediate-risk non–muscle invasive bladder cancer using UGN-102 results in a significant treatment response and encouraging durability."

"Intravesical nadofaragene firadenovec [recombinant adenovirus interferon alpha achieved a 53.4% CR rate in patients with BCG-unresponsive carcinoma in situ of the bladder."

Pembrolizumab plus enzalutamide in castration- resistant prostate cancer that exhibited enzalutamide resistance led to positive antitumor signals and a favorable safety profile, according to results of the phase II KEYNOTE-199  trial presented  at the 2020  Genitourinary Cancers Symposium.

The FDA has accepted and granted a priority review to a supplemental Biologics License Application for pembrolizumab for the treatment of adult and pediatric patients with unresectable or metastatic solid tumors with tissue tumor mutational burden-high who have progressed following prior treatment and who have no satisfactory alternative treatment options.

Stephen J. Freedland, MD, discusses real-world data for enzalutamide as treatment of patients with metastatic castration-resistant prostate cancer compared with data from the phase III PREVAIL study.

External Beam Radiation therapy with or without androgen deprivation therapy or surgery are the standards of care for men with intermediate-risk prostate cancer, but the adverse events associated with the treatments, delayed testosterone recovery and prolonged erectile dysfunction, are challenges.

An association was found between a lower risk of grade 3 or higher chemotherapy toxicity with higher body mass indexes and normal albumin, a protein made in the liver, levels in older adult patients with solid tumors, according to an analysis of a prospective, multicenter study.

A sudden surge in the cases of COVID-19 due to pandemic, along with efforts to contain it, has led to multiple challenges that no country has experienced in the last several decades. The global pandemic from COVID-19 poses a unique set of challenges not only for patients with cancer who need their treatment, but also for caregivers, oncologists, and the overall care team.

At the Annual Education Summit of the Medical Oncology Association of Southern California, Tanya Dorff, MD, discussed evolving practices in prostate and urothelial cancers as well as highlighted controversies in the treatment landscape such as the role of combination therapy in prostate cancer.

Liquid biopsy results that identify DNA damage repair genes in prostate cancer may be a useful tool in clinical-deci­sion making, espe­cially because these genes can elucidate therapeutic vulnera­bilities that could be exploited by current treatments.

Eugene B. Cone, MD, discusses the strategies for treating patients with prostate cancer who develop adverse events, such as cardiac events and immune-related events.