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Highlights from the 2023 ASCO Genitourinary Cancers Symposium
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HCRN GU 16-260, Nivolumab and Salvage Nivolumab+Ipilimumab in Patients with Advanced Renal Cell Carcinoma Cohort A, Treatment-Free Survival Outcomes
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Michael Atkins, MD
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| Michael Atkins joins Pedro Barata in a conversation on Cohort A of a phase II study looking at treatment-free survival (TFS) outcomes of nivolumab and salvage nivolumab + ipilimumab in advanced clear cell renal cell carcinoma (HCRN GU16-260).
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Cell-Free Urinary DNA Predictive Impact on Patients with Non-Muscle Invasive Bladder Cancer
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Kyle Rose, MD
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| Kyle Rose joins Sam Chang in discussing his team's findings regarding the impact of cell-free urinary DNA on non-muscle invasive bladder cancer patients.
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Oral Abstract Session C: Renal and Rare Tumors
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| ZIRCON: Results from Phase 3 Study of 89Zr-DFO-Girentuximab for PET/CT Imaging of Clear Cell Renal Cell Carcinoma |
| Brian M. Shuch, MD |
| The ZIRCON phase 3 pivotal study with 89Zr-DFO-girentuximab met its primary endpoint exceeding the sensitivity and specificity thresholds. Key secondary endpoints were met, demonstrating similar performance in small masses (cT1), exceeding the sensitivity and specificity thresholds.
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| Nivolumab plus Cabozantinib vs Sunitinib for First-Line Treatment of Advanced RCC: 3-Year Follow-up from the Phase 3 CheckMate 9ER Trial
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| Mauricio Burotto, MD
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| Mauricio Burotto reports survival, response per blinded independent central review, and safety after 3 year minimum follow-up in all randomized patients and by IMDC risk score. After 3 years of minimum follow-up, survival and response benefits were maintained with nivolumab plus cabozantinib and remained consistent with previous follow-ups.
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Poster Session B: Prostate Cancer and Urothelial Carcinoma
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| Oncologic Outcomes in Patients with Residual Invasive Upper Tract Urothelial Carcinoma Following Neoadjuvant Chemotherapy
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| Sean A. Fletcher, MD
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| It is often difficult to study patients with UTUC given its scarcity. For patients with advanced disease following radical nephroureterectomy, the POUT trial supports the use of adjuvant chemotherapy. However, many patients will be ineligible for cisplatin in this disease space. Thus, there is a growing body of literature supporting the use of neoadjuvant chemotherapy prior to radical nephroureterectomy for appropriately selected patients with upper tract urothelial carcinoma.
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| A SEER-Medicare Based Quality Score for Patients with Synchronous and Metachronous Metastatic Upper Tract Urothelial Carcinoma and Its Association with Cost of Care and Survival
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| Daniel D. Joyce, MD
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| These authors sought to evaluate the outcomes and costs associated with mUTUC and employ a novel methodology to identify both synchronous and metachronous mUTUC patients using claims data. Building off of this, they developed a guideline-based quality score to improve quality of care in this space.
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| Neoadjuvant Chemotherapy Versus Adjuvant Chemotherapy in Patients with Clinically Node-Positive Upper Tract Urothelial Cancer (UTUC) Who Underwent Radical Nephroureterectomy
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| Karan Jatwani, MD
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| In this retrospective analysis of outcomes among patients with clinically node positive UTUC who underwent a radical nephroureterectomy, neoadjuvant chemotherapy use, compared to adjuvant chemotherapy, was associated with a significantly improved overall survival hazard.
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| Radical Nephroureterectomy Followed by Adjuvant Chemotherapy Versus Observation in Early-Stage Upper Urinary Tract Cancers with Variant Histology
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| Karan Jatwani, MD
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| The POUT trial disproportionately included patients with urothelial predominant tumors.1 As such, the objective of this study was to evaluate outcomes of patients with UTUC variant histology who underwent adjuvant chemotherapy versus observation following an RNU.
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| Neoadjuvant Nivolumab + Ipilimumab in Cisplatin-Ineligible Patients with Upper Tract Urothelial Cancer
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| Min Yuen Teo, MD, MRCP
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| Here Min Yuen Teo and colleagues report the results from stage 1 of a phase II trial of neoadjuvant nivolumab and ipilimumab for UTUC. Key eligibility criteria included cisplatin-ineligibility and histologically confirmed high grade UTUC and/or evidence of radiographically-invasive disease with positive selective urine cytology.
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| Socioeconomic Vulnerability and the Risk of Genitourinary Cancer Mortality Among United States Counties
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| Anum Riaz, MBBS
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| While socioeconomic status has clearly recognized effects on general health outcomes and health care access, the association with genitourinary cancer mortality in the United States remains unclear. The authors of this analysis sought to address this knowledge gap.
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Poster Session C: Renal Cell Cancer; Adrenal, Penile, Urethral and Testicular Cancers
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| Evaluation of Deep Learning Techniques in RNA Sequencing Data for the Prediction of Response to Immune Checkpoint Inhibitors in Patients with Metastatic Renal Cell Cancer (mRCC)
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| Sandra Alonso Paz
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| The integration of clinical and molecular data could lead to more accurate predictions of outcome than any dataset by its own. However, further research is intended in the field of the deep learning analysis, as data codification and data structure could bias the results. The ongoing study ART (Artificial Intelligence in Renal Tumors) will address this issue prospectively.
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| C-Reactive Protein as a Predictive Marker for Outcomes with Avelumab + Axitinib in Patients with Poor-Risk Advanced Renal Cell Carcinoma: Exploratory Analysis from JAVELIN Renal 101
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| Yoshihiko Tomita, MD, Ph.D.
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| Analyses from the phase 3 JAVELIN Renal 101 trial suggested that CRP levels at baseline and early after treatment may predict outcomes with avelumab + axitinib in patients with advanced RCC. In addition, many patients with International Metastatic RCC Database Consortium poor risk who had prolonged progression-free survival and overall survival were observed at the third interim analysis of OS.
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| A Phase II Trial of Combination of PD-1 Immune Checkpoint Inhibition with All-Lesion Stereotactic Radiation in Oligometastatic Renal Cell Carcinoma
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| Jing Liu, MD Ph.D.
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| The five-year survival rates for patients with metastatic RCC remain poor. Through the abscopal effect, SBRT may theoretically improve the antitumor immunity of PD-1 immune checkpoint inhibition in metastatic RCC. Patients with oligometastatic RCC have a low tumor load and favorable prognosis. As such, they represent a prime target for combination SBRT and systemic therapy within the setting of future trials.
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| Adjuvant Pembrolizumab for RCC Across UCLA Integrated Staging System Risk Groups and Disease Stage: Subgroup Analysis from the KEYNOTE-564 Study
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| Toni K. Choueiri, MD
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| The objective of this analysis was to explore the efficacy of adjuvant pembrolizumab in subgroups of patients with ccRCC enrolled in the KEYNOTE-564 study based on UISS risk groups and disease stage. Results of this exploratory analysis further support the use of adjuvant pembrolizumab after nephrectomy as standard of care for patients with RCC at increased risk of recurrence.
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| Accuracy of Fully Automated, AI-Generated Models Compared with Validated Clinical Model to Predict Post-Operative Glomerular Filtration Rate After Renal Surgery |
| Nour Abdallah, MD
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| This data demonstrates the feasibility of a fully automated prediction of postoperative GFR based on CT imaging and baseline GFR with comparable predictive accuracy to existing validated clinical prediction models. Importantly, these AI-generated predictions can be implemented for decision-making, with no clinical details, clinician time, or measurements needed. This is key in increasing utilization. |
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| Burden of Surgeries and Surgical Complications in Patients with Von Hippel Lindau (VHL) Disease Before and After Treatment with Belzutifan
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| Yizhen Lai, MSc
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In this abstract, Yizhen Lai and colleagues present on the impact of belzutifan (HIF2 inhibitor) on burden of surgery and surgical complications in patients with Von Hippel Lindau (VHL). This study aimed to quantify the annual rate and costs of VHL-related surgeries and surgical complications before and after belzutifan initiation.
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| Impact of Chemotherapy on Anxiety, Depression, and Suicidality Amongst Testicular Cancer Survivors
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| Tyler J. Nelson, BS |
| Chemotherapy for testicular cancer is highly effective yet associated with significant consequences on long-term health-related quality of life. This study evaluated the impact of chemotherapy on anxiety, depression, and suicidality amongst testicular cancer survivors.
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Rapid Abstract Session: Renal Cell Cancer and Rare Tumors
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| CaboPoint: Interim Results from a Phase 2 Study of Cabozantinib after Checkpoint Inhibitor Therapy in Patients with Advanced Renal Cell Carcinoma
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| Laurence Albiges, MD, PhD
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| Over the past few years, the treatment landscape for patients with aRCC has been revolutionized. Combination therapy relying on a CPI backbone has become the standard of care. However, optimal second (and later) line treatment approaches remain to be better defined. One potential treatment approach is the use of cabozantinib, a multi-target TKI originally approved as a second line treatment after prior VEGF-targeted therapy.
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| Interim Analysis of the Prospective COTRIMS (Cologne Trial of Retroperitoneal Lymphadenectomy in Metastatic Seminoma) Trial |
| Tim Nestler, MD |
| Despite a high cure rate of 90% to 94% and 82% to 90% in CS IIA and IIB, respectively, both therapeutic options are associated with significant long-term toxicities, especially in seminomas beyond 15 years. The aim of this trial was to evaluate the feasibility, oncological efficacy and treatment associated morbidity of primary nerve sparing RPLND in stage IIA/B seminoma.
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| Safety and Efficacy of Immune Checkpoint Inhibitors in Advanced Penile Squamous Cell Carcinoma: An International Study from the Global Society of Rare Genitourinary Tumors
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| Talal El Zarif, MD
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| In the largest retrospective cohort of ICI-treated advanced PeCa, ICI showed no new safety signals, however, overall anti-tumor activity was limited. Future translational studies are needed to identify pts that are more likely to derive clinical benefit from ICI
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