ASCO 2018: CABOPRE: Phase II Study of Cabozantinib Prior to Cytoreductive Nephrectomy in Locally Advanced and/or Metastatic Renal Cell Carcinoma

Chicago, IL (UroToday.com) The current standard of care for patients with metastatic RCC is cytoreductive nephrectomy, followed by vascular endothelial growth factor (VEGF) tyrosine kinase inhibitor (TKI) therapy. With this type of therapy, patients need to recover from their surgery before starting TKI therapy. Up to 50% of patients do not receive TKI therapy in a timely manner.

ASCO 2018: State-of-the-Art Management of Germ Cell Cancer

Chicago, IL (UroToday.com) Darren Feldman, MD, gave an outstanding talk on practical points in the management of germ cell tumors (GCTs). Despite an increasing incidence and the fact that it is the most common cancer in men aged 15-24, GCT remains a rare disease. It is the rarity of this disease that increases the risks of errors being made. Additionally, it is noteworthy that in the last 15 years no new drugs have been approved for GCT treatment.

In this talk, Dr. Feldman reviewed some common and important principles and pitfalls in diagnosis and workup, early-stage disease, and advanced disease.

ASCO 2018: PROPHECY - A Prospective Trial of Circulating Tumor Cell AR-V7 Detection in mCRPC with Abiraterone or Enzalutamide

Chicago, IL (UroToday.com) Enzalutamide and abiraterone improve progression-free survival and overall survival in men with metastatic castration-resistant prostate cancer1,2. However, a small proportion of men have primary resistance to enzalutamide or abiraterone, and essentially all men develop secondary resistance3.

ASCO 2018: NIVES study: A Phase II Trial of Nivolumab Plus Stereotactic Body Radiotherapy in II And III Line of Patients with Metastatic Renal Cell Carcinoma

Chicago, IL (UroToday.com) There have been great advances in the medical treatment of patients with metastatic RCC (MRCC). However, despite these significant advances, the 5-year survival rate of these patients is still approximately 10%. Stereotactic body radiotherapy (SBRT) is a focused radiotherapy, delivering high dose radiation directly to the tumor. Its advantage is that it destroys more tumor cells and causes less damage to adjacent healthy tissue.

ASCO 2018: Leveraging Social Media to Advance Cancer Research: Challenges and Opportunities

Chicago, IL (UroToday.com) Mina Sedrak, MD, discussed the challenges and opportunities to leverage social media to advanced cancer research. Over the last decade, social media adoption has increased substantially, with 5% of adults in the US having at least one social media site in 2006 to 69% in 2018. Furthermore, health-related social media activities are on the rise, with the use of disease-specific hashtags, such as prostate cancer (#pcsm), kidney cancer (#kcsm), and bladder cancer (#blcsm) for incorporating better streamlining of information.

ASCO 2018: KEYNOTE-199: Pembrolizumab for docetaxel-refractory Metastatic Castration-Resistant Prostate Cancer (mCRPC).

Chicago, IL (UroToday.com) Early anti PD-1 studies with prostate cancer have had mixed results.  In the first study of PD-1 blockade in prostate cancer, 0% (0/17) of patients had an objective response1. However, in a subsequent study (KEYNOTE-028), the cohort of patients with prostate cancer had a 13% (3/23) overall response rate with an impressive median duration of response of 59 weeks2. During this ASCO, Julie Nicole Graff, MD, presented data on pembrolizumab in combination with enzalutamide in patients who progressed on enzalutamide, which demonstrated a 25% (3/12) radiographic response rate3.

ASCO 2018: KEYNOTE-564: A Phase 3, Randomized, Double Blind, Trial of Pembrolizumab in the Adjuvant Treatment of Renal Cell Carcinoma

Chicago, IL (UroToday.com) There are plenty of effective adjuvant therapies for patients with renal cell carcinoma (RCC), who are at risk for recurrence after nephrectomy [1,2]. Treatment with inhibitors of the vascular endothelial growth factor receptor (VEGFR) have been extensively studied in the setting of adjuvant treatment. However, they are currently not recommended as treatment.
The expression of programmed death 1 (PD-1) ligands 1 (PD-L1) and 2 (PD-L2) could potentially predict poor prognosis in clear cell RCC disease. Furthermore, PD1 inhibitors were shown to have activity in metastatic RCC patients, and PD-1 may represent a new therapeutic target in the adjuvant setting. Pembrolizumab, a PD-1 inhibitor, has been shown to have antitumor activity with a relatively good safety profile in several tumors.
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