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Highlights from the 2024 ASCO Genitourinary Cancers Symposium |
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| Defining Molecular Features Associated with Microsatellite Instability and Response to Immune Checkpoint Blockade in Urothelial Carcinoma |
| Syed Muneeb Alam, MD |
| Syed Muneeb Alam presented a study investigating molecular features associated with microsatellite instability (MSI) in urothelial carcinoma. The research revealed that MSI-high (MSI-H) urothelial carcinoma exhibits a distinct genomic profile, enriched in FGFR3 and chromatin-modifying gene alterations, and demonstrates superior overall survival with immune checkpoint blockade. |
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| Outcomes in Patients with Advanced Urothelial Carcinoma Treated with Enfortumab Vedotin After Switch Maintenance Avelumab in the UNITE Study |
| Amanda Nizam, MD |
| Amanda Nizam presents outcomes in patients with advanced urothelial carcinoma who received enfortumab vedotin after switch maintenance avelumab in the UNITE study. The findings suggest that patients treated with enfortumab vedotin after maintenance avelumab exhibited outcomes consistent with existing data for enfortumab vedotin in platinum-based therapy- and checkpoint inhibitor-refractory advanced urothelial carcinoma, emphasizing the potential of enfortumab vedotin as third-line therapy after progression on maintenance avelumab. |
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| HER2 and PD-L1 Immunohistochemistry Expression, and HER2 Genomic Alterations: Associations and Clinical Outcomes for Advanced Bladder Cancer |
| David H. Aggen, MD, Ph.D. |
| David Aggen discussed the outcomes of HER2 and PD-L1 immunohistochemistry expression and HER2 genomic alterations in advanced bladder cancer. The study identified ERBB2 alterations in approximately 20% of urothelial cancers, with 52% of tumors showing HER2 2+ or 3+ expression. The findings emphasize the need for further investigation of HER2-targeted agents and the importance of standardizing HER2 expression assessment by immunohistochemistry. |
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| FGFR3 Mutated Urothelial Carcinoma of Bladder or Upper Tract: A Comparative Genomic Landscape Study |
| Michael Basin, MD |
| Michael Basin discusses a comparative genomic landscape study of FGFR3 mutated urothelial carcinoma of the bladder or upper tract. The study found that FGFR3 mutation status was more frequent in upper tract urothelial carcinoma compared to bladder urothelial carcinoma. The findings suggest potential implications for clinical trial designs, including the evaluation of combinations of anti-FGFR3 targeted therapies with other agents such as immunotherapies and antibody-drug conjugates. |
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| Predictive Value of Dynamic Changes in ctDNA and Baseline Biomarkers with Neoadjuvant Atezolizumab in Operable Urothelial Carcinoma in the ABACUS Trial |
| Matthew Young, MD |
| Matthew Young discussed the predictive value of dynamic changes in circulating tumor DNA (ctDNA) and baseline biomarkers with neoadjuvant atezolizumab in operable urothelial carcinoma in the ABACUS trial. The study found that ctDNA clearance appears more accurate than 75% or 50% reduction in variant allele frequency to predict response or relapse, and combining ctDNA with tissue-based biomarkers improved biomarker accuracy. |
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| Urachal and Non-urachal Adenocarcinomas of the Bladder: A Comparative Comprehensive Genomic Profiling Study |
| Antonio Cigliola, MD |
| Antonio Cigliola discussed a comparative comprehensive genomic profiling study of urachal and non-urachal adenocarcinomas of the bladder. While TP53 and KRAS were the most frequent alterations in both groups, genomic alterations characteristic of colorectal adenocarcinoma, such as SMAD4 and GNAS, were more common in urachal adenocarcinoma, while mutations typical of urothelial carcinoma, including TERT and RB1, were prevalent in non-urachal adenocarcinoma. |
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| Oral APL-1202 in Combination with Tislelizumab as Neoadjuvant Therapy in Patients with MIBC: Interim Analysis of ANTICIPATE Phase II Trial |
| Matthew Galsky, MD |
| Matthew Galsky presented the interim analysis of the ANTICIPATE phase II trial, assessing oral APL-1202 in combination with tislelizumab as neoadjuvant therapy in patients with muscle-invasive bladder cancer. The pathologic complete response rates in both the combination and tislelizumab alone groups exceeded thresholds to trigger expansion to stage 2 of the 2-stage design, indicating potential efficacy and an acceptable safety profile for neoadjuvant APL-1202 + tislelizumab. |
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| Optimizing Treatment Strategies for Patients with Positive Pelvic/Retroperitoneal Lymph Nodes – Complete Clinical Response: Now What? |
| Monika Joshi, MD, MRCP |
| Monika Joshi discusses optimized treatment strategies for patients with positive pelvic and/or retroperitoneal lymph nodes in urothelial carcinoma. She highlights the role of systemic therapies in patients with lymph node-positive, and non-metastatic bladder cancer and discusses the challenges and strategies for managing patients with a complete clinical response. |
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| Safety and Efficacy of Enfortumab Vedotin in Patients with Metastatic/locally Advanced Urothelial Cancer: Real-World Evidence from a European Database |
| Stefanie Zschaebitz, MD |
| Stefanie Zschaebitz discussed the safety and efficacy of enfortumab vedotin (EV) in patients with metastatic/locally advanced urothelial cancer based on real-world evidence from a European database. The presentation highlighted the importance of future research focusing on biomarkers predicting response and toxicity to EV, as well as evaluating the efficacy and toxicity of combination therapy with EV and pembrolizumab in real-world populations. |
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| Economic Burden of Radical Cystectomy and Trimodal Therapy for Bladder Cancer in the United States: Real-World Study
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| Stephen Williams, MD, MBA, MS, FACS, FACHE
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| Stephen Williams presented a real-world analysis on the economic burden of radical cystectomy (RC) and trimodal therapy (TMT) for bladder cancer in the United States. The study, utilizing Optum Clinformatics® DataMart claims, revealed that while Medicare was the predominant payer, both RC and TMT incurred substantial costs, with RC having higher initial inpatient costs and TMT showing higher outpatient service-related expenses over time.
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| Updated Results from AVENANCE: Real-World Effectiveness of Avelumab First-Line Maintenance in Patients with Advanced Urothelial Carcinoma and Analysis of Subsequent Treatment |
| Philippe Barthelemy, MD, Ph.D. |
| Philippe Barthelemy presented updated results from AVENANCE, a real-world study evaluating the effectiveness of avelumab first-line maintenance in patients with advanced urothelial carcinoma. The study showed that the median overall survival from the start of avelumab treatment was 21.3 months, and 1- and 2-year overall survival rates were 67% and 46%, respectively. |
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| Avelumab First-Line Maintenance for Advanced Urothelial Carcinoma: Long-Term Patient-Reported Outcomes in the Phase 3 JAVELIN Bladder 100 Trial
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| Petros Grivas, MD, Ph.D.
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| Petros Grivas presented long-term patient-reported outcomes from the JAVELIN Bladder 100 trial, which evaluated avelumab first-line maintenance in patients with advanced urothelial carcinoma. The trial showed that avelumab + best supportive care prolonged overall survival compared to BSC alone.
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| Urine-Based Testing for Patient Selection and Genomic Characterization of Patients with FGFR Alteration-Positive NMIBC Treated with TAR-210 |
| Roger Li, MD |
| Roger Li presented findings on urine-based testing for patient selection and genomic characterization of individuals with FGFR alteration-positive non-muscle-invasive bladder cancer (NMIBC) treated with TAR-210. The study utilized a urine cell-free DNA diagnostic assay, PredicineCARE, to identify patients with FGFR alterations for treatment with TAR-210, an intravesical drug delivery system releasing erdafitinib. |
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| ABLE-41: Nadofaragene Firadenovec-Vncg Early Use and Outcomes in a Real-World Setting in the United States |
| Siamak Daneshmand, MD |
| Sia Daneshmand discussed the trial design of ABLE-41, evaluating nadofaragene firadenovec-vncg early use and outcomes in a real-world setting in the United States. This observational study aims to assess the effectiveness, overall experiences, patterns of use, and safety of nadofaragene firadenovec in patients with BCG-unresponsive NMIBC in the U.S. Nadofaragene firadenovec is the first FDA-approved intravesical gene therapy for high-risk BCG-unresponsive NMIBC with carcinoma in situ ± papillary tumors. |
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