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Bladder Cancer Highlights from the 2021 Genitourinary Cancers Symposium |
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| Avelumab First-Line Maintenance Plus Best Supportive Care vs Best Supportive Care Alone For Advanced Urothelial Carcinoma: JAVELIN Bladder 100 Subgroup Analysis Based On Duration And Cycles Of First-Line Chemotherapy
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| Yohann Loriot, MD, Ph.D.
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| Yohann Loriot presented results of a post hoc analysis of the JAVELIN Bladder 100 trial, specifically, efficacy by duration or number of cycles of first-line chemotherapy. Improved overall survival was observed with avelumab first-line maintenance versus best supportive care alone irrespective of duration or cycles of first-line chemotherapy received prior to entering the trial.
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| SURE: An Open Label, Sequential-Arm, Phase II Study of Neoadjuvant Sacituzumab Govitecan, and Sacituzumab Govitecan plus Pembrolizumab Before Radical Cystectomy, for Patients with MIBC Who Cannot Receive or Refuse Cisplatin-Based Chemotherapy
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| Andrea Necchi, MD
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| Andrea Necchi presented the trial design for the SURE trial, aiming to evaluate the efficacy of neoadjuvant sacituzumab govitecan either as a single-agent (SURE-01) or combined with pembrolizumab (SURE-02) before radical cystectomy. The primary endpoint of the study is to assess the proportion of ypT0N0.
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| Impact of Subsequent Therapy on Survival in KEYNOTE-361: Pembrolizumab (Pembro) plus Chemotherapy (Chemo) or Pembro Alone Versus Chemo as First-Line Therapy for Advanced Urothelial Carcinoma |
| Ajjai Alva, MBBS, MD |
| Ajjai Alva presented an exploratory analysis of overall survival by subsequent therapy among patients enrolled in KEYNOTE-361 to assess how first and second-line therapy selection affected survival. This exploratory analysis suggests that the sequence of initial chemotherapy followed by anti–PD-(L)1 agent may optimize outcomes and emphasizes the role of second-line immunotherapy. |
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| Pembrolizumab for the Treatment of Patients with High-Risk Non-Muscle-Invasive Bladder Cancer Unresponsive to Bacillus Calmette-Guérin: Extended Follow-up of KEYNOTE-057 Cohort A
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| Arjun Balar, MD
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| Arjun Balar presented updated efficacy and safety results with an extended minimum follow-up of 26.3 months from KEYNOTE-057 cohort A. Results from this analysis provide compelling evidence that pembrolizumab should be considered an effective nonsurgical treatment option in patients with BCG-unresponsive CIS of the bladder who are ineligible for or decline to undergo radical cystectomy.
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| Optimal Therapy for BCG-Unresponsive Non-Muscle-Invasive Bladder Cancer in the Non-cystectomy Candidate - Intravesical
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| Peter Black, MD
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| This year's ASCO GU session on optimizing personalized management of non-muscle invasive bladder cancer included a debate regarding the optimal therapy for BCG-unresponsive disease among patients that are not cystectomy candidates. Peter Black made the argument for intravesical therapy as the optimal treatment.
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| Optimal Therapy for BCG-Unresponsive Non-Muscle-Invasive Bladder Cancer in the Non-cystectomy Candidate - Systemic |
| Arjun Balar, MD |
| Following Peter Black's presentation, Arjun Balar made the argument for systemic therapy as the optimal treatment for BCG-unresponsive disease among patients that are not cystectomy candidates. Dr. Balar notes that high-risk non-muscle invasive bladder cancer is a disease of systemic potential in need of systemic therapy. |
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| Alignment and Discordances in Perceptions and Experiences of Shared Decision Making Among Bladder Cancer Patients and Their Care Team |
| Karim Chamie, MD |
| Karim Chamie presented results of a study assessing alignment and discordances on aspects of shared decision-making among bladder cancer patients and their urology and oncology teams. These data highlight essential alignments and discordances between patients and their care teams regarding bladder cancer and shared decision-making, which may inform future educational initiatives. |
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| Approaches to Immune Checkpoint Inhibitor Maintenance Therapy in Metastatic Urothelial Cancer: A Qualitative Analysis of Oncology Providers in the United States |
| Petros Grivas, MD, Ph.D. |
| Petros Grivas presented results of the study of a quality analysis of oncology providers in the US with regards to their approaches to immune checkpoint inhibitor maintenance therapy for metastatic urothelial carcinoma. This was a qualitative interview study with US oncologists and oncology nurses treating patients with metastatic urothelial carcinoma in academic and community practices. |
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| Treatment Patterns Among Patients with Advanced Urothelial Carcinoma Following Discontinuation of PD1/L1 Inhibitor Therapy
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| Alicia K. Morgans, MD, MPH
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| Alicia Morgans presented the results of a retrospective chart review aimed at characterizing the clinical characteristics and treatments among patients with locally advanced and metastatic urothelial carcinoma following discontinuation of first-line or second-line PD-1/L1i therapy.
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| An Open-Label, Multicenter, Phase IIIb Study of Patients With Urinary Tract Carcinoma (STRONG): Final Analysis for Fixed-Dose Durvalumab Monotherapy (Module A)
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| Guru Sonpavde, MD
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| Guru Sonpavde presented data from the STRONG study, aimed at understanding of long-term safety and efficacy of durvalumab in platinum and non-platinum pretreated patients, using a fixed-dose every 4 weeks. Based on the results, this data demonstrated, fixed-dose durvalumab monotherapy administered every 4 weeks is convenient with an acceptable safety profile in this patient population.
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| Efficacy of Enfortumab Vedotin in Advanced Urothelial Cancer: Retrospective Analysis of the Urothelial Cancer Network To Investigate Therapeutic Experiences (UNITE) Study
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| Vadim S Koshkin, MD
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| While enfortumab vedotin has been FDA approved, Vadim Koshkin conducted an assessment of its activity in particular patient subsets of interest including those with distinct histological variants. In this observational dataset, the data demonstrated that responses to enfortumab vedotin were present across a variety of subgroups of patients with advanced urothelial cancer, with significant differences between subgroup strata.
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| Genomic Characterization of Bladder Cancer with Variant Histology
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| Andrew Thomas Lenis, MD, MS
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| While the preponderance of patients with bladder tumors have urothelial histology, up to 25% of tumors are of pure variant or mixed urothelial and variant histology. These variant histologies are associated with more advanced stage at presentation and worse response to systemic therapy. In a poster presentation at the 2021 ASCO GU Cancers Symposium, Andrew Lenis presented a genomic analysis of bladder cancers with variant histology.
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| Safety and Efficacy Of Perioperative Cisplatin/Gemcitabine And Durvalumab For Operable Muscle-Invasive Urothelial Carcinoma: SAKK 06/17 |
| Richard Cathomas, PD Dr. med |
| Richard Cathomas presented preliminary results of SAKK 06/17 assessing safety and efficacy using perioperative cisplatin/gemcitabine plus durvalumab for patients with muscle-invasive urothelial carcinoma. SAKK 06/17 is an open-label, single arm, phase II trial for patients with operable muscle-invasive urothelial carcinoma cT2-T4a/cN0-1. |
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| Best of Journals: Urothelial Cancer - Medical Oncology
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| Scot A. Niglio, MD, MS
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| During the Best of Journals: Urothelial Cancer Session at the 2021 ASCO GU meeting, Scot Niglio provided the medical oncology perspective, highlighting what he felt to be the four key papers published in urothelial cancer in the past year.
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| Best of Journals: Urothelial Cancer - Surgery
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| Lindsey A. Herrel, MD
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| Lindsey Herrel provided the surgical/urology perspective during the Best of Journals: Urothelial Cancer session, highlighting what she felt to be the key papers published in urothelial cancer in the past year, emphasizing three key themes: new and emerging approaches to the treatment of BCG-unresponsive non-muscle invasive bladder cancer, evaluation of robotic radical cystectomy, and the feasibility of radical cystectomy following neoadjuvant immunotherapy.
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| Best of Journals: Urothelial Cancer - Radiation Oncology |
| Abhishek Solanki, MD |
| Abhishek Solanki provided the radiation oncology perspective, highlighting what he felt to be the key papers published in urothelial cancer in the past year, highlighting four main themes: 1) Trimodal therapy for bladder cancer, and the resulting quality of life. 2) Evolutions in radiotherapy (RT) for bladder cancer including adaptive RT and intensity-modulated RT. 3) Increasing access to local therapy due to advances in technology, and finally 4) the role of stereotactic body radiotherapy in patients with oligometastatic disease. |
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| To view our full coverage of the 2021 ASCO GU Symposium, visit the Conference Coverage section on UroToday.com |
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