Ronald Chen: Good to see you, Tian.
Tian Zhang: So tell us a little bit about your oral presentation here at ASCO.
Ronald Chen: So the AMBASSADOR Trial is a trial for patients with high-risk urothelial carcinoma after radical surgery. For these patients, they have a 60 to 70% chance of recurrence after surgery, so there's a need for adjuvant therapy. It's a trial led by Dr. Apolo through the Alliance, it's an NCCN trial. And the primary results were published last year, which showed that pembrolizumab adjuvant therapy compared to observation doubled the progression-free survival, doubled the disease-free survival from 14 to 29 months, so that's really great.
What I'm presenting here at ASCO are the quality of life results. I think patients and physicians want to know not only does adjuvant therapy improve disease control, but how does it really impact patient's quality of life?
Tian Zhang: Awesome. And what did you learn about patient's quality of life in the adjuvant setting for bladder cancer?
Ronald Chen: So in the Ambassador Trial, we assessed quality of life using two instruments. We used the uRT-C instrument, which included the QLQ-C30, commonly used across cancer trials. And we also added to that a bladder cancer supplement, uRT-C BLM-30. And then we also assess EQ-5D.
So in these two quality of instruments, we assess patient reported symptoms like dyspnea, nausea, vomiting, fatigue. Patients reported on their physical function, whether they're able to perform roles, overall quality of life, and that's what we're presenting.
So, some of the results were not surprising. We found that patients on the pembrolizumab alum had more fatigue and more dyspnea. I think that's well-known described side effects of pembro. But I think these symptoms also were associated with more limitations and functions, so being able to do activities daily living and also strenuous activities, and some impact on work and hobbies. These impacts were modest level. There was no overall impact on quality of life, which is good news.
Tian Zhang: Awesome. Do you think in the adjuvant setting where our patients are getting a lot of checkpoint inhibitors now, is that quality of life impacting them to make that decision of whether or not they want to go on these adjuvant treatments?
Ronald Chen: I think patients do want to know how the side effects of pembro, for example, impact their ability to function, and I think we're able to describe that. There is impact, but it's a modest impact, so I think that will inform patient decision making. But I think even more important, if we're finding that some patients do have limitations in being able to do ADLs or work or their hobbies, maybe that's also a call for supportive services that we can watch out for cancer survivors after treatment.
Tian Zhang: Yeah, no, really important work. So UroToday's audience has a lot of community oncologists too. What's your advice to them as they're giving adjuvant nivolumab, pembrolizumab in their community settings?
Ronald Chen: I think the biggest thing is that I think we now provide data to help patients understand the impact of symptoms on their quality of life. And also I think it's a call for us to screen for patients' need for supportive services after treatment, even a year or two after treatment.
Tian Zhang: Thanks so much for joining us, Ron.
Ronald Chen: Good to see you.