Genitourinary Cancers Symposium

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.

Stereotactic body radiotherapy combined with nivolumab was associated with “high” 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 a broad-spectrum tyrosine kinase inhibitor with an immune checkpoint inhibitor resulted in a high disease control rate in a preliminary dose-finding trial involving patients with advanced clear cell renal cell carcinoma.

A fourth of patients with advanced clear cell renal cell carcinoma responded to single-agent therapy with an oral hypoxia-inducible factor–2α inhibitor, which achieved a disease control rate of 80%, a preliminary clinical trial showed.

Nivolumab plus gemcitabine and cisplatin administered in the neoadjuvant setting to patients with muscle-invasive bladder cancer resulted in a pathologic nonmuscle-invasive rate of 66% and a pathologic complete response rate of 49%.

Bradley McGregor, MD, clinical director, Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, senior physician, instructor in medicine, Harvard Medical School, discusses the goals of the phase III CheckMate-9ER trial, which is evaluating cabozantinib combined with nivolumab in previously untreated patients with advanced or metastatic renal cell carcinoma (RCC).

The combination of durvalumab and olaparib may have activity as neoadjuvant therapy in the treatment of muscle-invasive bladder carcinoma.

Alexandra Drakaki, MD, assistant professor of medicine, hematology, and oncology, University of California, Los Angeles, discusses the goals of the phase Ib/II MORPHEUS trial, which is an umbrella study evaluating several second-line immunotherapy combinations in patients with advanced or metastatic urothelial carcinoma.

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;

Monika Joshi, MD, MRCP, associate professor of medicine, Division of Hematology-Oncology, and co-leader for Genitourinary Disease Team, at Penn State Hershey Cancer Institute, discusses the phase Ib/II results of a trial looking at concurrent durvalumab and radiation therapy followed by adjuvant durvalumab in patients with locally advanced urothelial cancer of the bladder.

Edwin M. Posadas, MD, medical director, Urologic Oncology Program, co-director, Translational Oncology Program, associate professor, Medicine, Cedars-Sinai Medical Center, discusses key takeaways from the ARAMIS trial of darolutamide in high-risk nonmetastatic castration-resistant prostate cancer.

Mark T. Fleming, MD, medical oncologist, Virginia Oncology Associates, The US Oncology Research, discusses exciting data seen with antiandrogen agents for the treatment of prostate cancer.

Tanya Dorff, MD, discusses recent data with olaparib (Lynparza) in castration-resistant prostate cancer and the future role of PARP inhibitors in this disease.<br /> &nbsp;

First-line treatment with single-agent pembrolizumab induced a 24.8% overall response rate in patients with&nbsp;non-clear cell renal cell carcinoma, according to&nbsp;findings from cohort B of the phase II KEYNOTE-427 trial that were presented during the 2019 Genitourinary Cancers Symposium.<br /> &nbsp;

According to phase I findings from a dose-escalation cohort presented during the 2019 Genitourinary Cancers Symposium, the combination of pembrolizumab and cabozantinib demonstrated antitumor activity in patients with previously treated metastatic renal cell carcinoma and is tolerated at their approved doses for this indication.

Retrospective findings reported during the&nbsp;2019 Genitourinary Cancers Symposium showed&nbsp;patients with metastatic castration-resistant prostate cancer who received radium-223 dichloride with abiraterone acetate in a layered fashion experienced a lower rate of symptomatic skeletal events compared with those who received the treatments concurrently.

Adding&nbsp;enzalutamide (Xtandi) to androgen deprivation therapy led to&nbsp;prolonged radiographic progression-free survival compared with ADT alone in men with metastatic hormone-sensitive prostate cancer, investigators reported during the&nbsp;2019 Genitourinary Cancers Symposium.

According to data from the&nbsp;phase III ARAMIS trial presented during the&nbsp;2019 Genitourinary Cancers Symposium, darolutamide added to androgen deprivation therapy significantly improved metastasis-free survival compared with placebo plus ADT in patients with nonmetastatic castration-resistant prostate cancer.

Raoul S. Concepcion, MD, FACS, director, Comprehensive Prostate Center, discusses takeaways from the ARAMIS study of darolutamide in patients with nonmetastatic castration-resistant prostate cancer.

In updated 30-month follow-up data from the&nbsp;phase III CheckMate-214 trial, nivolumab combined with low-dose ipilimumab sustained strong responses and a survival benefit as a frontline treatment for patients with intermediate- and poor-risk advanced renal cell carcinoma.

Although&nbsp;African-American men are at a higher risk for&nbsp;metastatic castration-resistant prostate cancer and have worse survival outcomes compared with Caucasian men, findings of a recent retrospective study suggested they may have a better response to several prostate cancer treatments.

Findings from the phase III KEYNOTE-426 study demonstrated a significantly improved progression-free survival and overall survival with the combination&nbsp;pembrolizumab plus axitinib versus&nbsp;sunitinib in previously-untreated patients with&nbsp;clear cell metastatic renal cell carcinoma, according to a prescast ahead of the&nbsp;2019 Genitourinary Cancers Symposium.

Treatment with the&nbsp;novel targeted radiation therapy lutetium-177 PSMA-617 demonstrated&nbsp;strong clinical activity and the potential to improve survival in heavily pretreated men with PSMA-positive metastatic castration-resistant prostate cancer, according to phase II findings to be presented at the 2019 Genitourinary Cancers Symposium.

Patients with renal cell carcinoma (RCC) who express higher entropy, a measure of T-cell diversity, could translate to a more favorable prognosis

Novel clinical trials are currently assessing the combination of VEGF-targeted agents and immune checkpoint inhibitors as frontline therapies for patients with metastatic renal cell carcinoma (RCC).

Combining a selective class I oral histone deactylase (HDAC) inhibitor with high-dose interleukin (IL)-2 may boost the latter's antitumor effect in renal cell carcinoma (RCC).

Nivolumab shows consistent survival benefit across subgroups as a second-line treatment for renal cell carcinoma (RCC), according to data from an analysis of the phase III CheckMate-025 trial.

Gulley says there are currently a variety of phase III studies looking at new treatments for use in bladder cancer, despite some widely-used agents, such as nivolumab and pembrolizumab, already being approved for other cancer types like melanoma and lung cancer, though not bladder cancer.