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| Evaluating Chemotherapy De-Escalation in First-Line Urothelial Carcinoma: DISCUS Trial |
| Enrique Grande, MD, PhD, MSc |
| Professor Enrique Grande joins Ashish Kamat to discuss the DISCUS trial, a phase II study comparing three versus six cycles of platinum-based chemotherapy before avelumab maintenance in first-line metastatic urothelial carcinoma. |
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Highlights from the 2025 European Society of Medical Oncology Annual Meeting
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| ALBAN: A Phase 3, Randomized, Open-Label, International Study of IV Atezolizumab and Intravesical BCG versus BCG Alone in BCG-Naïve High-Risk NMIBC
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| Morgan Roupret, MD, PhD
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| The phase 3 ALBAN trial evaluated IV atezolizumab plus intravesical BCG versus BCG alone in BCG-naïve high-risk NMIBC and found no significant improvement in event-free survival (HR 0.98, p = 0.91). While the safety profile was consistent with known effects of each drug, higher rates of grade ≥3 adverse events occurred with the combination. Dr. Roupret emphasized the need for biomarker-guided patient selection and optimization of checkpoint inhibitor use in future NMIBC studies.
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| Durvalumab in Combination with BCG for BCG-Naïve High-Risk NMIBC: Final Analysis of the Phase 3, Open-Label, Randomized POTOMAC Trial |
| Maria De Santis, MD |
| The phase 3 POTOMAC trial demonstrated that adding durvalumab to BCG (induction + maintenance) significantly improved disease-free survival in BCG-naïve, high-risk NMIBC patients, with a 32% reduction in recurrence or death risk. No overall survival detriment or major quality-of-life impact was observed. The combination showed a manageable safety profile, supporting durvalumab + BCG as a potential new standard for this population. |
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| DISCUS: A Phase II Study Comparing 3 Versus 6 Cycles of Platinum-Based Chemotherapy Prior to Maintenance Avelumab in Advanced Urothelial Cancer |
| Enrique Grande, MD, PhD, MSc |
| The phase II DISCUS trial found that 3 cycles of platinum-based chemotherapy before maintenance avelumab provided better quality of life compared to 6 cycles, with no loss in efficacy—median overall survival was 18.9 months in both arms. More patients in the 3-cycle arm transitioned to avelumab maintenance, suggesting shorter chemotherapy may optimize tolerability and treatment continuity in advanced urothelial cancer. |
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| Adjuvant Nivolumab Versus Placebo for High-Risk Muscle Invasive Urothelial Carcinoma: 5-Year Efficacy and ctDNA Results from CheckMate 274 |
| Matthew Galsky, MD |
| At 5-year follow-up, the CheckMate 274 trial confirmed sustained disease-free survival and overall survival benefits with adjuvant nivolumab versus placebo in patients with high-risk muscle-invasive urothelial carcinoma, particularly in PD-L1 ≥1% tumors. Exploratory ctDNA analysis showed that patients with detectable ctDNA derived significant benefit from nivolumab, while undetectable ctDNA was strongly associated with long-term remission. |
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| A Blinded, Exploratory Phase 2 Trial of Nivolumab and the GDF-15 Neutralizing Antibody Visugromab or Placebo as Neoadjuvant Treatment of Patients with MIBC: Primary Results of the GDFather-NEO Trial |
| Andrea Necchi, MD |
| The GDFather-NEO phase 2 trial showed that adding the GDF-15 neutralizing antibody visugromab to neoadjuvant nivolumab substantially improved pathologic and radiologic responses in cisplatin-ineligible or -refusing patients with muscle-invasive bladder cancer, with pathologic complete response rates of 33.3% versus 7.1% and major pathologic response rates of 66.7% versus 21.4% compared to nivolumab alone. The combination was well tolerated, with no grade 4/5 treatment-related adverse events, supporting further investigation in larger neoadjuvant trials and potential bladder-preserving strategies. |
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| Insights on PETRANHA (Saruparib + ARPI) and Pasritamig (JNJ-78278343) in Advanced Prostate Cancer |
| Pasquale Rescigno, MD |
| Pasquale Rescigno discussed two innovative prostate cancer studies: PETRANHA and Pasritamig. Early results from PETRANHA showed that combining saruparib, a selective PARP inhibitor, with AR pathway inhibitors achieved strong biochemical responses—especially in mCSPC—with manageable toxicity and lower discontinuation rates, warranting confirmation in phase 3 trials. |
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