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Highlights from the 2022 American Society of Clinical Oncology Annual Meeting |
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| Oral Abstract Session - Kidney and Bladder
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| Results From Cohorts 3, 4, 5 of the COSMIC-021 Study - Cabozantinib in Combination With Atezolizumab in Urothelial Carcinoma |
| Sumanta K. Pal, FASCO, MD
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| In this presentation, Monty Pal presented the results from cohorts 3, 4 and 5 of COSMIC-021. In these cohorts, patients with locally advanced or metastatic transitional cell urothelial carcinoma who were ineligible for surgery were treated with cabozantinib and atezolizumab.
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| A Randomized, Double Blind, Phase II Clinical Trial of Maintenance Cabozantinib Following Chemotherapy for Metastatic Urothelial Carcinoma: Final Analysis of the ATLANTIS Cabozantinib Comparison |
| Robert J. Jones, MD |
| Robert Jones discussed the final analysis of the ATLANTIS trial, a randomized, double blind, phase II clinical trial of maintenance cabozantinib following chemotherapy for metastatic urothelial carcinoma. Though underpowered, this study does not support further investigation of cabozantinib alone as a maintenance therapy after platinum-based chemotherapy in unselected patients with advanced urothelial cancer. Negative patient selection for DRD and androgen receptor biomarkers may bias interpretation. |
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| Is There a Role for VEGF-TKIs in Bladder Cancer? |
| Shilpa Gupta, MD |
| In this discussion, Shilpa Gupta reviewed data presented in abstracts 4505 and 4506 that evaluated cabozantinib as either combination therapy with atezolizumab or single-agent maintenance therapy in advanced urothelial cancer. |
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| TRUCE-02: An Open Label, Single-Arm, Phase II Study of Tislelizumab Combined With Nab-Paclitaxel for High-Risk Non-Muscle-Invasive Urothelial Bladder Carcinoma |
| Zesheng An, MD |
| Zesheng An discussed the results of TRUCE-02, an open label, single-arm, phase II study of tislelizumab combined with nab-paclitaxel for high-risk non-muscle-invasive bladder carcinoma (NMIBC). Tislelizumab with nab-paclitaxel represents a novel treatment option with a satisfactory benefit in treating NMIBC. This therapeutic regimen showed acceptable immune-related adverse events, with grade 3-4 adverse events less than 2%. |
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| Final Clinical Results of Pivotal Trial of IL-15RαFc Superagonist N-803 With BCG in BCG-Unresponsive CIS and Papillary NMIBC |
| Karim Chamie, MD |
| Karim Chamie discussed the final results of the trial assessing IL-15RαFc superagonist N-803 with BCG in BCG-unresponsive CIS and papillary NMIBC. In these patients with BCG-unresponsive NMIBC, there is a 99% bladder cancer specific overall survival at 2 years. In CIS patients 71% complete response rate with 26.6 months median duration of response, and 53% disease-free survival rate at 18 months in papillary disease. |
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| Expanding Horizons in Localized Bladder Cancer - Discussion |
| Michiel S. Van Der Heijden, MD, Ph.D. |
Michiel Van Der Heijden discussed expanding horizons in localized bladder cancer. Dr. Van Der Heijden discussed “Cell-free DNA methylation as a predictive biomarker of response to neoadjuvant chemotherapy for patients with muscle-invasive bladder cancer in SWOG S1314” by Dr. Thomas Flaig, “TRUCE-02: An open label, single-arm, phase II study of tislelizumab combined with nab-paclitaxel for high-risk non-muscle-invasive urothelial bladder carcinoma” by Dr. Zesheng An, and “Final clinical results of pivotal trial of IL-15RαFc superagonist N-803 with BCG in BCG-unresponsive CIS and papillary NMIBC” by Dr. Karim Chamie.
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| Cell-Free DNA Methylation as a Predictive Biomarker of Response to Neoadjuvant Chemotherapy for Patients with Muscle-Invasive Bladder Cancer in SWOG S1314
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| Thomas W. Flaig, MD
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| Thomas Flaig discussed cell-free DNA methylation as a predictive biomarker of response to neoadjuvant chemotherapy for patients with muscle-invasive bladder cancer in SWOG S1314. The aim of the current study presented by Dr. Flaig was to characterize cell-free DNA methylation from patients receiving neoadjuvant chemotherapy in SWOG S1314, a prospective cooperative group trial, and to correlate the methylation signatures with pathologic response.
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| Poster Session: Genitourinary Cancer--Kidney and Bladder
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| PSMA PET-CT for Advanced Renal Cell Carcinoma |
| Shivanshan Pathmanathan, MD |
| Shivanshan Pathmanathan discussing PSMA PET-CT for advanced RCC. The proPSMA study demonstrated that PSMA PET-CT provides accurate staging for prostate cancer, however the PSMA protein is also expressed in non-prostate malignancies, including in the neovasculature of solid organ tumors such as RCC. There is an emerging role of the use of PSMA PET in RCC. At the 2022 ASCO meeting, Dr. Pathmanathan and colleagues reported their experience using of PSMA PET-CT in recurrent or metastatic RCC. |
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| LITESPARK-004 (MK-6482-004) Phase 2 Study of Belzutifan, an Oral HIF-2α Inhibitor, for Von Hippel-Lindau Disease: Update With More Than Two Years of Follow-Up Data |
| Eric Jonasch, MD |
| Eric Jonasch discussed the updated results of the LITESPARK-004 phase 2 study of belzutifan, an oral hypoxia-inducible factor 2α inhibitor (HIF-2α), for von Hippel-Lindau (VHL) disease. After a median follow-up of 29.3 months, belzutifan continued to show antitumor activity in VHL disease–related neoplasms, including RCC, pNETs, and CNS hemangioblastomas. These results support the use of belzutifan as a systemic treatment for VHL disease. |
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| Real-World Treatment Patterns and Clinical Outcomes with First-Line Therapy in Cisplatin-Eligible and Ineligible Patients with Advanced Urothelial Carcinoma |
| Guru Sonpavde, MD |
| Guru Sonpavde examined the real-world treatment patterns and outcomes for patients receiving first-line therapy for advanced urothelial carcinoma. Dr. Sonpavde concluded that clinical outcomes remain generally poor for patients with advanced UC receiving first-line therapy, with particularly worse outcomes for those who are cisplatin ineligible. Further, many patients did not receive first-line therapy and, among those who did, the majority did not receive second-line therapy. |
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| Efficacy and Safety of Atezolizumab Concurrent with Radiotherapy in Patients with Muscle-Invasive Bladder Cancer: An Interim Analysis of the ATEZOBLADDERPRESERVE Phase II Trial (SOGUG-2017-a-IEC(VEJ)-4) |
| Sergio Vazquez-Estevez, MD |
| Sergio Vazquez-Estevez discussed the interim results from the ATEZOBLADDERPRESERVE trial of atezolizumab in combination with radiotherapy as a bladder preserving treatment for patients with muscle invasive bladder cancer (MIBC). These interim results suggest that the combination of atezolizumab and concurrent radiotherapy is a feasible and effective treatment for MIBC with favourable pathologic complete response rates and a manageable safety profile. |
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| Efficacy of Hyperthermic-Intra-Vesical Chemotherapy in Patients with BCG-Refractory Nonmuscle-Invasive Bladder Cancer |
| Geraldine Pignot, MD |
| Geraldine Pignot regarding the role of hyperthermic-intra-vesical chemotherapy as treatment for patients with BCG-refractory non-muscle invasive bladder cancer (NMIBC). Chemohyperthermia using the HIVEC device achieved a RFS rate of 53.1% at 1 year and enabled a bladder preservation rate of 90%. While cystectomy remains the standard of care for patients with BCG-refractory NIMBC, HIVEC may be discussed cautiously for patients who are not eligible for surgery and well informed of the risk of progression to muscle-invasive disease. |
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| A Phase 3 Study of the Subcutaneous Programmed Cell Death Protein 1 Inhibitor Sasanlimab as Single Agent for Patients with Bacillus Calmette-Guérin, Unresponsive High-Risk, Non-Muscle Invasive Bladder Cancer: CREST Study Cohort B |
| Neal Shore, MD, FACS |
| Neal Shore described the rationale and design of the CREST Study Cohort B, examining sasanlimab as monotherapy in patients with bacillus Calmette-Guérin (BCG) unresponsive high-risk, non-muscle invasive bladder cancer (NMIBC). This study will initially open for recruitment in Canada and the United States of America, with subsequent sites in Asia, Australia, and Europe. |
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