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Highlights from the American Urological Association Annual Meeting
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| Long-Term Recurrence Free Survival Following UGN-101 Treatment for Low-Grade Upper Tract Urothelial Carcinoma
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| Karim Chamie, MD, MSHS
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| The AUA 2021 virtual annual meeting included a late-breaking abstract session with a presentation by Dr. Karim Chamie discussing long-term recurrence free survival following UGN-101 treatment for low-grade upper tract urothelial carcinoma. Long-term follow up suggests treatment with UGN-101 for low-grade upper tract urothelial carcinoma can result in a lengthy period of durable response and may exceed that achieved by surgical nephron-sparing approaches such as laser ablation.
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| Suicidality in Urologic Cancer Patients
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| Zachary Klaassen, MD
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| In the Society of Urologic Oncology (SUO) plenary session held at the American Urological Association (AUA) Virtual Annual Meeting, Dr. Zachary Klaassen addressed the question of suicidality in urologic cancer patients. After many years of little attention, there has been increasing interest in understanding the mental health of patients with cancer.
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| Initial Results from a Phase 1/2 Trial of Large Surface Area Microparticle Docetaxel for High-Risk Non-Muscle Invasive Bladder Cancer
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| Max Kates, MD
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| In this abstract by Max Kates, he reports on the safety and preliminary efficacy of a large surface area microparticle docetaxel (LSAM-DTX) for the treatment of patients with high-risk non-muscle-invasive bladder cancer (NMIBC). LSAM-DTX treatment was safe by both intramural injection and intravesical instillations, at all doses. Preliminary efficacy data suggest post-TURBT intramural injection and intravesical instillation of high dose LSAM-DTX may prevent recurrence in patients with hrNMIBC for 6-months.
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| Novel Weekly Immunotherapy Dosing with Avelumab Tolerated During BCG Induction Therapy: Initial Results of the ABC Trial
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| Kelly Stratton, MD, FACS
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| In this presentation at the American Urological Association (AUA) annual meeting, Dr. Kelly Stratton presents the initial results of the ABC trial, an open-label Phase Ib trial of BCG therapy in conjunction with avelumab for patients with BCG unresponsive non-muscle invasive bladder cancer (NMIBC). From a safety standpoint, they found that induction therapy with combined BCG and avelumab was safe and well-tolerated.
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| Persistent Deficiencies in the Measurement and Reporting of Tobacco Use in Contemporary Genitourinary Oncology Clinical Trials
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| Calvin Zhao, BS
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| In this late breaking abstract, Calvin Zhao delves into the reporting of tobacco use in contemporary GU clinical trials and found that it is rarely collected or reported. Considering the impact of smoking on the development of GU malignancies, this is a deficiency that needs to be addressed.
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| The Future of Neoadjuvant Therapy in Bladder Cancer |
| Elizabeth Kessler, MD |
| The Society of Urologic Oncology (SUO) session at the 2021 American Urological Association, (AUA) virtual annual meeting included a presentation by Dr. Elizabeth Kessler discussing the future of neoadjuvant therapy in bladder cancer. Dr. Kessler concluded her presentation with the following take home messages; If we take care of a complex patient population, the treatment options will likely increase the pool of people potentially eligible for neoadjuvant therapy. The future will help us decide when, what and why to treat patients. |
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| Quality of Life After Cystectomy and Urinary Diversions |
| Scott Gilbert, MD |
| The bladder cancer session at the Society of Urologic Oncology’s (SUO) program at the AUA 2021 virtual annual meeting included a presentation by Scott Gilbert who discussed the quality of life after cystectomy and urinary diversions. Health-related quality of life measures and outcomes should be leveraged in a more proactive and productive way, including being compulsory about inclusion in randomized clinical trial design, and integrated into yet-to-be-developed educational resources that support surgeon counseling and patient decision-making. |
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| Updated Treatment Results from a Phase I Study of WST11 Phototherapy (VTP) for Upper Tract Urothelial Carcinoma
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| Lucas Nogueira, MD
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| In a podium presentation at the American Urological Association Annual Meeting, Lucas Nogueira and colleagues presented results from a phase 1 dose-finding study of WST11-VTP of the upper tract. Dr. Nogueira suggested that WST11-VTP shows promising efficacy in the treatment of patients with low- and high-grade upper tract urothelial tumors with limited treatment-related toxicity. These data support a larger, multicenter trial which is planned.
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| Primary Chemoablation of Low-Grade Intermediate-Risk Non-Muscle-Invasive Bladder Cancer Using UGN-102, a Mitomycin-Containing Reverse Thermal Gel (OPTIMA II): A Phase 2b, Open-Label, Single-Arm Trial |
| William Huang, MD |
| William Huang and colleagues presented an analysis of the efficacy and safety of UGN-102, a mitomycin-containing reverse thermal gel, as primary chemoablative therapy in patients with LG IR NMIBC. Dr. Huang concluded that primary chemoablation of LG IR NMIBC using UGN-102 results in a high rate of disease eradication with encouraging durability and may provide an alternative to repetitive surgery for these patients. These preliminary data form the basis for an ongoing phase 3, randomized, controlled trial of UGN-102 for treatment of LG IR NMIBC. |
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| Individualized Mutation Detection in Plasma and Urinary Circulating Tumor DNA for Monitoring Upper Tract Urothelial Carcinoma Using Digital Polymerase Chain Reaction |
| Daichi Tamura, MD |
| Daichi Tamura presented the results of their study evaluating the validity of plasma and urinary ctDNA as a tumor biomarker in UTUC. In UTUC, VAFs of plasma and urinary ctDNA were related to tumor burden and, thus, ctDNA could be a useful biomarker of UTUC. However, this work requires further validation. |
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| A Urine-Based DNA Methylation Marker Test to Detect Upper Tract Urothelial Carcinoma: A Pilot Study |
| Alireza Ghoreifi, MD |
| Alireza Ghoreifi and colleagues presented their analysis exploring the feasibility of a urine-based epigenetic assay to detect UTUC. This pilot study has demonstrated that a urine-based epigenetic assay has high sensitivity and negative predictive value in the diagnosis of patients with UTUC. These results however require validation. |
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| Risk of Secondary Malignancies After Pelvic Radiation: A Population-Based Analysis |
| Andrew Salib, MD |
| In this analysis by Andrew Salib and colleagues, the authors explore on a larger scale the risk of developing secondary malignancies after pelvic radiation therapy for a primary pelvic malignancy (rectal/anal, bladder, prostate, uterine, cervical). While confirming that radiation treatment for pelvic malignancies increases the risk of developing secondary malignancies over the patient’s lifetime, the risk is different depending on the primary tumor histology. |
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| Avelumab First-Line Maintenance Plus Best Supportive Care vs Best Supportive Care Alone for Advanced Urothelial Carcinoma: Analysis of Time to End of Next-Line Therapy in JAVELIN Bladder 100 |
| Joaquim Bellmunt, MD, Ph.D. |
| Joaquim Bellmunt reports a secondary analysis from the JAVELIN Bladder 100 trial, of time to end of next-line therapy in patients treated with avelumab vs. best supportive care (BSC). Based on the data, Dr. Bellmunt concludes that patients who received avelumab 1L maintenance+BSC had prolonged time to end of next-line treatment vs those who received BSC alone, irrespective of PD-L1 status, which provides further evidence of the efficacy of a maintenance approach with avelumab in pts with advanced UC that have not progressed with 1L platinum-based chemotherapy. |
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| Perioperative Intravesical Chemotherapy in Minimally Invasive Radical Nephroureterectomy for Upper Tract Urothelial Carcinoma: Low but Increasing Utilization Worldwide
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| Alexander Kenigsberg, MD
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| In this presentation by Alexander Kenigsberg, at the American Urological Association (AUA) annual meeting, he evaluates the usage of intravesical chemotherapy in the perioperative setting following radical nephroureterectomy for upper tract urothelial carcinoma. While utilization remains low, they note that usage is increasing worldwide.
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| Avelumab First-Line Maintenance for Advanced Urothelial Carcinoma: Analysis of Clinical and Genomic Subgroups From the JAVELIN Bladder 100 Trial
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| Joaquim Bellmunt, MD, Ph.D.
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| Joaquim Bellmunt reports a post hoc analysis of the JAVELIN Bladder 100 trial in previously unreported clinical and genomic subgroups. Based on this data, it can be concluded that OS benefit was seen for avelumab 1L maintenance+BSC vs BSC alone across subgroups of interest. These results are consistent with previously reported findings, further supporting avelumab 1L maintenance as a standard of care for pts with advanced UC that have not progressed with 1L platinum-containing chemotherapy.
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| Female Patients With Low-Grade Upper Tract Urothelial Carcinoma: Primary Chemoablation and Durability of Response in a Subgroup Analysis From the OLYMPUS Trial
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| Jennifer Linehan, MD
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| In this study by Jennifer Linehan, she discusses the outcomes of female patients from the OLYMPUS trial, in which patients with low-grade upper tract urothelial carcinoma (LG-UTUC) were treated with a novel reverse thermal gel containing mitomycin. Female patients in the OLYMPUS trial demonstrated CR, durability of CR, and patient-reported AE’s similar to male patients in the overall study population.
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| To view our full coverage of the 2021 AUA Annual Meeting, visit the Conference Coverage section on UroToday.com |
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