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Highlights from the 2024 ASCO Genitourinary Cancers Symposium |
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| CONTACT-02: Phase 3 Study of Cabozantinib + Atezolizumab vs Second Novel Hormonal Therapy in Patients with mCRPC
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| Neeraj Agarwal, MD
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| In the CONTACT-02 phase 3 study, cabozantinib plus atezolizumab demonstrated a significant improvement in radiographic PFS compared to a second novel hormonal therapy in patients with mCRPC who had progressed on a prior novel hormonal therapy. The benefits of radiographic PFS were particularly notable in patients with liver metastasis and those who previously received docetaxel for metastatic castration-sensitive prostate cancer.
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| Long-Term Results of Dose Escalation (80 vs 70 Gy) Combined with Long-Term Androgen Deprivation in High-Risk Prostate Cancer: GETUG-AFU 18 Randomized Trial
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| Christophe Hennequin, MD, Ph.D.
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| The long-term results of the GETUG-AFU 18 randomized trial demonstrate that dose escalation combined with long-term androgen deprivation in high-risk prostate cancer significantly improves progression-free survival, prostate cancer-specific survival, and overall survival, without increasing toxicity. Even with long-term androgen deprivation therapy, higher-dose radiotherapy is established as a new standard of care in managing high-risk localized prostate cancer.
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| Multicentre Prospective Evaluation of Cognitive Function in Patients with Metastatic Castrate-Resistant Prostate Cancer Treated with Abiraterone Acetate or Enzalutamide: The ACE Study
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| Amit Bahl, MD, FRCP, FRCR
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| Amit Bahl discusses the ACE study which evaluated cognitive function in metastatic castrate-resistant prostate cancer (mCRPC) patients treated with abiraterone acetate or enzalutamide. Based on the data, the study suggests the importance of considering patient-reported outcomes for treatment optimization and supportive strategies in mCRPC patients using these drugs.
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| Differences in Genomic, Transcriptomic, and Immune Landscape of Prostate Cancer Based on Site of Metastasis
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| Umang Swami, MD, MS
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| Umang Swami presents a study that analyzed the genomic, transcriptomic, and immune landscapes of prostate cancer based on the site of metastasis. Using a large dataset, the researchers found significant differences between primary prostate cancer and metastatic lesions. Liver metastases had higher frequencies of RB1, APC, and AR mutations, lower AR signaling, T-cell inflamed, and IFN-γ signatures, and higher NEPC scores.
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| Defining Molecular Features Associated with Microsatellite Instability and Response to Immune Checkpoint Blockade in Urothelial Carcinoma |
| Syed Muneeb Ala |
| Syed Muneeb Alam presents the findings on defining molecular features associated with microsatellite instability (MSI) and response to immune checkpoint blockade in urothelial carcinoma. MSI-H urothelial carcinoma demonstrated a distinct genomic profile with high tumor mutational burden, enrichment in FGFR3 and chromatin modifying gene alterations, and a sensitivity to immune checkpoint blockade, leading to superior overall survival. |
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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 discusses outcomes in patients with advanced urothelial carcinoma treated with enfortumab vedotin after switch maintenance avelumab in the UNITE study. The results indicated that patients had outcomes consistent with enfortumab vedotin data in platinum-based therapy- and checkpoint inhibitor-refractory advanced urothelial carcinoma, with higher Bellmunt scores associated with worse outcomes. |
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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
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| Matthew N. Young, MD
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| 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 a 75% or 50% reduction in variant allele frequency to predict response or relapse, and combining ctDNA with baseline biomarkers improved biomarker accuracy.
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| Urinary Minimal Residual Disease Detection Predicts Recurrence in BCG-Unresponsive NIMBC and Quantifies Molecular Response to Nadofaragene Firadenovec |
| Vikram M. Narayan, MD |
| Vikram Narayan presentes a study on urinary minimal residual disease (MRD) detection predicting recurrence in BCG-unresponsive NIMBC and quantifying molecular response to nadofaragene firadenovec. The study, which included 43 patients with BCG-unresponsive NMIBC, utilized the UroAmp MRD assay for urinary MRD testing. |
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| Adjuvant Nivolumab Monotherapy vs Placebo for Localized RCC at High Risk of Relapse After Nephrectomy: Results from Part B of the Randomized, Phase 3 CheckMate 914 Trial |
| Robert J. Motzer, MD |
| Robert Motzer presented results from Part B of the phase 3 CheckMate 914 trial at the 2024 GU ASCO annual meeting. The trial evaluated adjuvant nivolumab monotherapy versus placebo for localized RCC at high risk of relapse after nephrectomy. While the primary endpoint of disease-free survival per blinded independent central review was not met, with a hazard ratio of 0.87, the median disease-free survival was not reached in either arm. |
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| Overall Survival Results from the Phase 3 KEYNOTE-564 Study of Adjuvant Pembrolizumab vs Placebo for the Treatment of Clear Cell RCC |
| Toni K. Choueiri, MD |
| Toni Choueiri presented overall survival results from the phase 3 KEYNOTE-564 study, which assessed adjuvant pembrolizumab versus placebo for the treatment of clear cell RCC. The study included participants with clear cell RCC at an increased risk of recurrence following surgery. The trial showed a statistically significant improvement in overall survival with pembrolizumab compared to placebo, including a 38% reduction in the risk of death. |
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| Subcutaneous Nivolumab Versus Intravenous Nivolumab in Patients With Previously Treated Advanced or Metastatic Clear Cell Renal Cell Carcinoma: Pharmacokinetics, Efficacy, and Safety Results From CheckMate 67T |
| Saby George, MD, FACP |
| Results from the CheckMate 67T study comparing subcutaneous (SC) and intravenous (IV) administration of nivolumab in advanced clear cell RCC demonstrated that SC nivolumab met co-primary pharmacokinetic endpoints, showing non-inferiority in exposures and efficacy compared to IV nivolumab. The safety profile of SC nivolumab was consistent with IV administration, supporting its use as a new option to reduce treatment burden and improve healthcare efficiency. |
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| Belzutifan Versus Everolimus in Participants With Previously Treated Advanced Renal Cell Carcinoma: Patient-Reported Outcomes in the Phase 3 LITESPARK-005 Study |
| Thomas Powles, MBBS, MRCP, MD |
| Thomas Powles discusses the phase 3 LITESPARK-005 study of patient-reported outcomes in individuals with previously treated advanced RCC. LITESPARK-005 data showed improvements in progression-free survival and objective response rate with belzutifan and highlights the efficacy of belzutifan for kidney cancer. |
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