Featured Videos

SAN FRANCISCO, CA USA (UroToday.com) - Complete Title: GU Cancers Symposium 2014 - The initial report of RTOG 0524: Phase I/II trial of a combination of paclitaxel and trastuzumab with daily irradiation or paclitaxel alone with daily irradiation following transurethral surgery for noncystectomy candidates with muscle-invasive bladder cancer - Session Highlights

Dr. M. Dror Michaelson and colleagues reported on the RTOG 0524 trial, looking at the safety and efficacy of trimodality, organ-preserving therapy in patients with UC overexpress HER2/neu, who were not suitable for radical cystectomy. Patients with invasive bladder UC (stages T2-T4a, N0-1, M0) who underwent cystoscopic tumor resection were analyzed by HER2/neu immunohistochemistry (IHC) and assigned to chemotherapy groups I (IHC 2+ or 3+; paclitaxel and trastuzumab) or II (IHC negative or 1+; paclitaxel alone). Concurrent weekly paclitaxel (50 mg/m2), weekly trastuzumab (group I only) and daily radiation (64.8 Gy total in 36 fractions) were also given for seven consecutive weeks. The primary endpoint of the study was acute protocol-defined toxicity related to treatment.

gucancerssympalt thumbTwenty-one eligible patients were included in group I and 47 in group 2. Median ages were 80 and 73, respectively. Acute toxicity was observed in 7/21 patients (33%) in group I and 14/47 patients (30%) in group II. Most common grade > 3 adverse events in groups I and II were marrow suppression (43% and 17%), diarrhea (33% and 30%), and hyponatremia (14% and 4%). Three deaths on study were attributed to colonic perforation, pneumonia, and sudden death. Radiation completion rates were 72% and 85% in the two groups, and full-dose chemotherapy completion rates were 52% and 51%. Evaluation by cystoscopy and/or tumor biopsy at 12 weeks noted complete response in 9/13 patients (69%) in group I, in 19/33 patients (58%) in group II, and was not performed in the remaining patients.

They concluded that although the response rate for HER2/neu-targeted therapy is acceptable, it may also increase certain adverse events in this challenging population. Also, they show that trimodality bladder-preserving therapy can be an appropriate treatment in patient with invasive UC who do not have adequate cardiopulmonary reserve to undergo radical cystectomy.

Highlights of a presentation by M. Dror Michaelson, MD, PhD at the 2014 Genitourinary Cancers Symposium - January 30 - February 1, 2014 - San Francisco Marriott Marquis - San Francisco, California USA

Massachusetts General Hospital, Boston, MA USA

Written by Reza Mehrazin, MD, medical writer for UroToday.com


View Full 2014 GU Cancers Symposium Coverage

 

 

Clinical Trials
Searchable data base of currently enrolling clinical trials
Journals
Publications focusing on urological cancer treatments through original commentary & articles
Everyday Urology Volume 3 Issue 2

Everyday Urology™ - Oncology Insights

From the Editor

PCAN cover

Prostate Cancer and Prostatic Diseases

From the Editor

@UroToday
E-Newsletters

Newsletter subscription

Free Daily and Weekly newsletters offered by content of interest

The fields of GU Oncology and Urology are rapidly advancing. Sign up today for articles, videos, conference highlights and abstracts from peer-review publications by disease and condition delivered to your inbox and read on the go.

Subscribe

Calendar
Upcoming educational events
November 23-25, 2018 / European Society for Medical Oncology Asia 2018 Congress
European Society for Medical Oncology Asia 2018 Congress
November 25-30, 2018 / RSNA 2018 Annual Meeting
RSNA 2018 Annual Meeting