GENITOURINARY CANCERS

A 75-Year-Old Man With Metastatic Castrate-Resistant Prostate Cancer

A significant percentage of younger men with high-risk prostate cancer who display minimal comorbidities continue to receive&nbsp;nondefinitive therapy (NDT), despite research that has demonstrated local therapy is more beneficial in this patient population, according to findings from a study published in&nbsp;<em>JAMA Oncology</em>&nbsp;show. A number of reasons for this have been identified, including&nbsp;&nbsp;insurance status and race/ethnicity.

In an interview with&nbsp;Targeted Oncology, Kashyap Patel, MD, discussed the COVID-19 pandemic and the implementation of new precautions in his practice as the number of COVID-19 infected persons rises in the state.<br /> &nbsp;

The addition of 6 months of oral daily enzalutamide to standard salvage radiation and hormone therapy is safe and may improve prostate cancer remission rates at 2 and 3 years postoperatively among patients with high-risk disease, according to a recent paper in European Urology Oncology.

Elderly patients with advanced prostate cancer should be evaluated for preexisting cardiovascular diseases before taking oral androgen signaling inhibitors by a multidisciplinary team, includ&shy;ing a cardiologist, according to a recent retro&shy;spective study. Investigators at Thomas Jeffer&shy;son University in Philadelphia, Pennsylvania, demonstrated that after receiving abiraterone acetate&nbsp; or enzalutamide, these patients had higher rates of short-term mortality than similar patients without CVDs.

Patients harboring IDH1/2 muta&shy;tions may receive benefit by the use of PARP inhibitors, with investigators initi&shy;ating clinical trials in patients across multiple different tumor types to determine the efficacy of this strategy.

Treatment with pembrolizumab demonstrated antitumor activity along with tolerable toxicity in patients with 4 different rare and hard-to-treat malignancies, according to results from a phase II study led by The University of Texas MD Anderson Cancer Center researchers and published in the&nbsp;Journal for ImmunoTherapy of Cancer.

Neeraj Agarwal, MD, discusses the efficacy of cabozantinib and atezolizumab in the COSMIC-021 study.

To help assess the advances the United States has made in decreasing cancer-related deaths, a collective of public health bodies found that monitoring trends in cancer risk, screening test use, and mortality is informative. A report published in&nbsp;<em>Cancer</em>&nbsp;shows that progress has been made in recent years, but there is more work to be&nbsp;<a>done.</a>

African American males with prostate cancer may fare better in terms of overall survival than Caucasian males, according to the results of a pooled analysis of phase III data. The data were obtained through the PROCEED registry, which includes over 1900 patients with metastatic castration-resistant prostate cancer treated with sipuleucel-T, created at the recommendation of the FDA.

Patients with metastatic hormone-sensitive prostate cancer with a luminal B tumor are associated with better outcomes with the addition of docetaxel chemotherapy to androgen deprivation therapy compared with androgen deprivation therapy alone. In a correlative study presented at the 2020 Genitourinary Cancers Sumposium, investigators also determined that the basal tumor subtype did not experience as much of a survival benefit with the addition of docetaxel to androgen deprivation therapy.

The FDA has accepted a Biologics License Application for MYL-1402O, a proposed biosimilar to bevacizumab, according to a press release from co-developers Biocon and Mylan. The BLA is seeking approval for the biosimilar as a treatment for multiple types of cancer and the FDA has set an action date goal of December 27, 2020, for a decision on the BLA.

As the new coronavirus disease 2019 creates problems internationally, health-wise and economically, it is also becoming a cause for concern throughout the oncology community.

The addition of apalutamide to androgen deprivation treatment improved time to pain progression and other quality-of-life out&shy;come measures in patients with metastatic castration-sensitive prostate cancer in the phase III TITAN trial.

In February 2020, the FDA gave indications to multiple therapies meant for treatment of solid tumor and hematologic malignancies. FDA action included 10 Priority Reviews, 2 Breakthrough Therapy designations, and 2 Fast Track designations.

According to findings from a retrospective analysis published in&nbsp;JAMA Oncology,&nbsp;the testosterone-related genetic variant&nbsp;HSD3B1&nbsp;(1245C) is associated with more aggressive disease in patients with metastatic prostate cancer. This is the first clinical trial to validate the relationship between the variant and clinical outcomes, and the results may help physicians determine which patients are more likely to benefit from more aggressive therapy.

Patients with metastatic renal cell carcinoma in a real-world cohort of a retrospective analysis demonstrated positive activity and a favorable safety profile when receiving frontline tivozanib.

Stephen J. Freedland, MD, discussed&nbsp;an analysis real-world patients with metastatic castration-resistant prostate cancer, which he presented at the 2020 Genitourinary Cancers Symposium.

To help clinicians cope with an increasing number of geriatric patients with cancer, the Association of Community Cancer Centers is addressing this problem with a 2-pronged approach that focuses on the delivery of care and diagnostic assessment.

In an interview with&nbsp;Targeted Oncology, Martin T. King, MD, PhD,discusses INTREPId following his poster presentation of the trial design at the 2020 Genitourinary Cancer Symposium. He also discusses other another promising studies being presented at the conference.

Most patients with metastatic renal cell carcinoma whose disease progresses after immunotherapy given either alone or in combination with other agents receive subsequent treatment with VEGF tyrosine kinase inhibitors or mTOR inhibitors. When administered post-immunotherapy, cabozantinib is associated with superior median progression free survival, according to retrospective data from a real-world study of patients treated at 16 Italian referral centers.

William K. Oh, MD, discusses phase III studies in the prostate cancer setting which led to the use of these new treatments, such as androgen receptor targeted therapies with chemotherapy in earlier disease settings.

Stereotactic body radiotherapy combined with nivolumab was associated with &ldquo;high&rdquo; disease control and overall survival rates in a phase II study of pretreated patients with metastatic renal cell carcinoma, according to lead investigator Cristina Masini, MD, who presented the data at the 2020 Genitourinary Cancers Symposium.

Combining cabozantinib plus androgen-deprivation therapy as first-line therapy in patients with hormone-na&iuml;ve metastatic prostate cancer yields promising clinical activity, according to the new single-arm phase II study, which was published in Clinical Cancer Research.

Apalutamide plus androgen deprivation therapy reduced the risk of second progression or death regardless of hormonal or taxane therapy as the first subsequent life-prolonging therapy in patients with metastatic castration-sensitive prostate cancer.

Men with metastatic castration-resistant prostate cancer had inferior immune responses with the combination of sipuleucel-T and radium-223 but improved clinical outcomes as compared with sipuleucel-T alone, a small randomized trial showed.

Combining cabozantinib and atezolizumab induced durable responses in men with metastatic castration-resistant prostate cancer who had soft tissue progression after prior hormonal therapy.<br /> &nbsp;

The combination of cabozantinib in combination with atezolizumab demonstrated encouraging efficacy and tolerability in patients with metastatic castration-resistant prostate cancer, according to the updated results of the phase Ib COSMIC-021 trial. The trial &nbsp;is evaluating the combination in locally advanced or metastatic solid tumors, Elexis, Inc, announced in a press release.

In January 2020, the FDA approved new treatment options in gastrointestinal stromal tumors, bladder cancer, and epithelioid sarcoma. The FDA also granted several Priority Review Designations, orphan drug designations, and a Fast Track designation, as well as a Breakthrough Therapy designation.

A. Oliver Sartor, MD, discusses the current treatment options for patients with nonmetastatic castration-resistant prostate cancer (CRPC) and what physicians should consider when selecting treatment for their patients.