Bladder Cancer

In an interview with Targeted Oncology, Shilpa Gupta, MD, discussed the results of the BLASST-1 trial evaluating neoadjuvant nivolumab plus gemcitabine and cisplatin in patients with muscle-invasive bladder cancer undergoing a cystectomy. She highlighted the next steps and key points community oncologists need to know about these data now.

In February 2020, the FDA gave indications to multiple therapies meant for treatment of solid tumor and hematologic malignancies. FDA action included 10 Priority Reviews, 2 Breakthrough Therapy designations, and 2 Fast Track designations.

To help clinicians cope with an increasing number of geriatric patients with cancer, the Association of Community Cancer Centers is addressing this problem with a 2-pronged approach that focuses on the delivery of care and diagnostic assessment.

The FDA has granted Breakthrough Therapy Designation to enfortumab vedotin plus pembrolizumab for the treatment of patients with unresectable locally advanced or metastatic urothelial cancer who are unable to receive cisplatin-based chemotherapy in the first-line setting.

Stephen Boorjian, MD, discusses the efficacy results of the phase II study intravesical nadofaragene firadenovec in patients with high-grade, Bacillus Calmette-Guerin unresponsive nonmuscle invasive bladder cancer, which he presented at the 2020 Genitourinary Cancer Symposium. 

Nivolumab plus gemcitabine and cisplatin administered in the neoadjuvant setting to patients with muscle-invasive bladder cancer resulted in a pathologic nonmuscle-invasive rate of 66% and a pathologic complete response rate of 49%.

The combination of durvalumab and olaparib may have activity as neoadjuvant therapy in the treatment of muscle-invasive bladder carcinoma.

Frequencies of certain genomic mutations associated with upper tract urothelial carcinoma versus urothelial carcinoma of the bladder may serve as the rationale for differ­ing response rates, Sumati V. Gupta, MD, said during a presentation of the data at the 11th European Multidis­ciplinary Congress on Urological Cancers.

In January 2020, the FDA approved new treatment options in gastrointestinal stromal tumors, bladder cancer, and epithelioid sarcoma. The FDA also granted several Priority Review Designations, orphan drug designations, and a Fast Track designation, as well as a Breakthrough Therapy designation.

Tremelimumab monotherapy showed clinical activity with durable responses in patients with metastatic urothelial carcinoma and documented transitional cell carcinoma of the urothelium who failed first-line platinum-based chemotherapy, according to results from a phase II study, which is evaluating the drug in solid tumors.

In a phase II trial, the combination of lenvantinib and pembrolizumab demonstrated a manageable safety profile and encouraging antitumor activity in patients with selected advanced solid tumors. The decision to combine the agents was based on preclinical data, which suggested that VEGF and FGF signaling may enhance the therapeutic efficacy of lenvatinib.

Atezolizumab failed to meet the primary end point, disease-free survival, as adjuvant monotherapy in patients with muscle-invasive urothelial cancer compared with observation in the phase III IMvigor010 clinical trial, according to a press release from Roche, developer of the drug.

Integrating a geriatric assessment into the care of older adults who are receiving cancer treatment in communi­ty oncology practices improves patient and caregiver satisfaction and encourages commu­nication about aging-related concerns, accord­ing to results of a clinical trial that enrolled 541 patients with advanced cancer.

Shilpa Gupta, MD, explains the rationale for adding androgen receptor therapy to cisplatin- and gemcitabine-based chemotherapy.

The present and future benefits of telehealth in oncology can be observed through Tahoe For­est Cancer Center and its affiliation with the UC Davis Cancer Center, use of other remote clinics, and participation in virtual tumor boards. Even though there are roadblocks to telehealth reaching more locations and more patients, the potential benefit warrants the time needed to get over those hurdles.

Pembrolizumab is now FDA approved for the treatment of patients with Bacillus Calmette-Guerin–unresponsive, high-risk, non-muscle invasive bladder cancer with carcinoma in situ with or without papillary tumors who are ineligible for or have elected not to undergo cystectomy.

Overall survival was significantly improved in patients with locally advanced or metastatic urothelial cancer who received first-line maintenance treatment with avelumab versus standard of care, meeting the primary end point of the phase III JAVELIN Bladder 100 study, Pfizer announced in a press release.

The FDA has granted a&nbsp;<a>priority review designation to the new drug application&nbsp;</a>for UGN-101 for the potential treatment of patients with low-grade upper tract urothelial cancer, UroGen Pharma Ltd., announced in a press release.

Enfortumab vedotin-ejfv has been approved by the FDA for treatment of patients with locally advanced or metastatic urothelial cancers who had prior treatment with a PD-1 or PD-L1 inhibitor and a platinum-containing chemotherapy regimen, according to a press release from the FDA.<br /> &nbsp;

The FDA has granted priority review to a new supplemental Biologics License Application for pembrolizumab, for which Merck is seeking approval for the treatment of patients with Bacillus Calmette-Guerin-unresponsive, high-risk, non-muscle invasive bladder cancer with carcinoma-in-situ with or without papillary tumors who are either ineligible for cystectomy or have chosen not to undergo the procedure, according to a press release from Merck.

In patients whose solid<strong> </strong>tumors harbor a mutation in <em>KRAS </em>G12C, therapy with MRTX849 has produced promising responses and acceptable toxicity across 3 tumors types, according to data presented at the 2019 American Association for Cancer Research&ndash;National Cancer Institute&ndash;European Organization for Research and Treatment of Cancer International Conference on Molecular Targets and Cancer Therapeutics.

In an interview with&nbsp;Targeted Oncology, Pavlos Msaouel, MD, PhD, discussed the findings from the trial evaluating sitravatinib plus nivolumab in patients with advanced/metastatic urothelial carcinoma. He also highlighted the next steps for this combination regimen.