Startseite Kongressberichte & Archiv Genitourinary Cancers Symposium - Adrenal Cancer; Penile Cancer; Testicular Cancer; Urethral Cancer Oral Abstract Session & Rapid Abstract Session

Oral Abstract Session: Urothelial Carcinoma; and Adrenal, Penile, Testicular, and Urethral Cancers

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Imaging modality and frequency in surveillance of stage I seminoma testicular cancer: Results from a randomized, phase III, factorial trial (TRISST).
 
Johnathan K. Joffe, Fay H. Cafferty, Laura Murphy, et al.
 
The authors conclude: Surveillance is a safe management approach in stage I seminoma – advanced relapse is rare, salvage treatment successful, and long-term outcomes excellent, regardless of imaging frequency or modality. Relapse beyond 3 years is rare and imaging may be unnecessary. MRI is non-inferior to CT, avoids irradiation and should be recommended. Clinical trial information: NCT00589537
 
SEMS trial: Result of a prospective, multi-institutional phase II clinical trial of surgery in early metastatic seminoma.
 
Siamak Daneshmand, Clint Cary, Timothy A. Masterson, et al.
 
The authors conclude: This trial establishes RPLND as a therapeutic option as a first-line treatment in early metastatic seminoma. The surgery offers cancer control rates similar to those seen in non-seminomatous germ cell tumors. Clinical trial information: NCT02537548
 
Primary results of EV-301: A phase III trial of enfortumab vedotin versus chemotherapy in patients with previously treated locally advanced or metastatic urothelial carcinoma.
 
Thomas Powles, Jonathan E. Rosenberg, Guru Sonpavde, et al. 
 
The authors conclude: EV is the first therapy to show significant survival advantage over standard chemotherapy in patients with treatment-experienced la/mUC. With robust clinical benefit and a tolerable safety profile, EV is a new standard of care for this aggressive disease. Clinical trial information: NCT03474107
 

See also: ORIGINAL ARTICLE in NEJM: Enfortumab Vedotin in Previously Treated Advanced Urothelial Carcinoma

See also: New class of drug leads to 30% reduced risk of death for bladder cancer patients

 

EV-201 Cohort 2: Enfortumab vedotin in cisplatin-ineligible patients with locally advanced or metastatic urothelial cancer who received prior PD-1/PD-L1 inhibitors.
 
Arjun V. Balar, Bradley A. McGregor, et al.
 
The authors conclude: In EV-201 C2, the majority of platinum-naive, cis-ineligible la/mUC pts who progressed on/after PD-1/L1-i achieved durable responses to EV, with 1/5 achieving CR. PFS and OS were encouraging. Safety was consistent with the previously reported AE profile of EV, within the context of a patient population with advanced malignancy and comorbidity. These data show the potential for EV as a non-platinum option following PD-1/L1-i. Clinical trial information: NCT03219333
 

Rapid Abstract Session: Urothelial Carcinoma and Rare Tumors

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Cost-effectiveness analysis of pembrolizumab for BCG-unresponsive carcinoma in situ of the bladder.
 
Vidit Sharma, Kevin Wymer, Christopher Saigal, et al. 
 
The authors conclude:  Based on decision-analytic Markov modeling of treatment options for patients with BCG-unresponsive CIS, pembrolizumab was unlikely to be cost-effective without a > 90% price reduction. While both RCx and SIC were more cost-effective than pembrolizumab, further studies may validate the cost-effectiveness of gemcitabine-docetaxel relative to RCx if the recurrence and metastasis thresholds are met. Overall, our model supports the preferential use of RCx and SIC over pembrolizumab for BCG-unresponsive CIS.
 
Final results from a phase I trial and expansion cohorts of cabozantinib and nivolumab (CaboNivo) alone or with ipilimumab (CaboNivoIpi) for metastatic genitourinary tumors.
 
Andrea B. Apolo, Daniel d. Girardi, Scot A. Niglio, et al. 
 
The authors conclude: CaboNivo and CaboNivoIpi demonstrated promising clinical activity and manageable safety in many mGU histologies including rare tumors. Clinical trial information: NCT02496208
 
Phase II study of gemcitabine and split-dose cisplatin plus pembrolizumab as neoadjuvant therapy prior to radical cystectomy (RC) in patients with muscle-invasive bladder cancer (MIBC).
 
Tracy L. Rose, Michael R. Harrison, Allison M. Deal, et al. 
 
The authors conclude: Neoadjuvant GC + pembro was generally safe and met its primary endpoint for improved pathologic downstaging. Correlative analyses are ongoing. Additional investigation of this combination is warranted. Clinical trial information: NCT02690558
 
A phase II trial of risk enabled therapy after initiating neoadjuvant chemotherapy for bladder cancer (RETAIN BLADDER): Interim analysis.
 
Daniel M. Geynisman, Philip Abbosh, Eric A. Ross, et al. 
 
The authors conclude: Interim results of a phase II trial of risk enabled therapy utilizing a selection of clinical and genomic factors in pts with cT2-T3 MIBC demonstrates a 50% rate of any UC recurrence and a 11% rate of locally advanced/metastatic disease in the AS group. 89% of AS pts have retained their bladder. Follow-up continues for the primary endpoint of 2-year MFS. Clinical trial information: NCT02710734
 
Phase II clinical study of concurrent durvalumab and radiation therapy (DUART) followed by adjuvant durvalumab in patients with localized urothelial cancer of bladder: Results for primary analyses and survival. BTCRC-GU15-023.
 
Monika Joshi, Matthew Kaag, Leonard Tuanquin, et al. 
 
The authors conclude: DurvaRT followed by adjuvant durva demonstrated promising efficacy with 1-year PFS probability of 73%, 1- year OS probability of 83.8% and DCR of 70% in MIBC and locally advanced BC pts with comorbidities. Results will be updated prior to the final presentation. Efficacy was also seen in node (+) pts which led to the design of prospective randomized NCTN study. Induction chemo followed by chemo+durvaRT+ adjuvant durva vs. chemoRT combination is being evaluated in the ongoing EA8185 clinical trial (ECOG-ACRIN/NRG study) for node (+) BC pts. Clinical trial information: NCT02891161
 
Impact of equal access healthcare on race disparities in bladder cancer.
 
Nikhil V. Kotha, Abhishek Kumar, Edmund M. Qiao, et al. 
 
The authors conclude: While racial disparities for patients with bladder cancer in the SEER database were observed, no differences in survival outcomes between black and white patients were observed in the VA healthcare system. Of note, black veterans presented with more advanced stage, suggesting a delay in diagnosis or a more aggressive cancer phenotype compared to white patients. Our findings underscore the need to bridge healthcare disparities across diverse racial groups. Our study highlights the beneficial impact of an equal access healthcare system in reducing financial and social barriers to healthcare to counteract racial health disparities. Further research is required to delineate these disparities and guide appropriate screening strategies.
 
Phase II/III clinical results of IL-15RαFc superagonist N-803 with BCG in BCG-unresponsive non-muscle invasive bladder cancer (NMIBC) carcinoma in situ (CIS) patients.
 
et al. 
 
The authors conclude: With a CR rate of 72%, N-803 has met its primary endpoint with 59% probability of CR patients maintaining CR for at least 12 months. With the observed strong efficacy and an SAE rate of 1%, N-803 represents a novel treatment option for BCG unresponsive CIS with a favorable benefit:risk ratio, in a therapeutically challenging disease. Clinical trial information: NCT03022825