GENITOURINARY CANCERS

Based on results of the Ib/II Study 111, the combination of the PD-1 inhibitor pembrolizumab and the VEGF/FGF inhibitor lenvatinib has been granted a breakthrough therapy designation by the FDA for the treatment of patients with advanced and/or metastatic renal cell carcinoma.

Arjun Balar, MD, discusses novel immunotherapy combinations for the treatment of patients with bladder cancer.

With genetic screening for mutations and biomarkers gaining more prevalence in diagnosing and treating cancer, genetic testing and counseling for patients with prostate cancer is becoming a pressing concept that urologists need to better understand. At the 2017 LUGPA Annual Meeting, Leonard Gomella, MD, gave a presentation stressing the importance of integrating genetic testing into clinical practice.

Determining the sequence of therapies has yet to be wholly standardized for treating castration-resistant prostate cancer (CRPC), particularly in the case of abiraterone (Zytiga) and enzalutamide (Xtandi).

Therapeutic Management of Nonmetastatic Prostate Cancer

Therapeutic Approach for Nonmetastatic Prostate Cancer

The PD-L1 inhibitor avelumab (Bavencio) has been granted a breakthrough therapy designation by the FDA for use in combination with the VEGF inhibitor axitinib (Inlyta) in treatment-naïve patients with advanced renal cell carcinoma.

Based on data from the phase III SPARTAN trial, apalutamide has been granted a priority review by the FDA for the treatment of patients with nonmetastatic castration-resistant prostate cancer, according to Janssen Biotech, the manufacturer of the next-generation oral androgen receptor inhibitor.

Based on results of the CABOSUN trial, cabozantinib (Cabometyx) has been approved by the FDA for previously untreated patients with advanced renal cell carcinoma.

Based on findings of the phase III CheckMate-214 trial, a supplemental biologics license application for the combination of nivolumab and ipilimumab has been granted a priority review by the FDA as a frontline treatment for intermediate- and poor-risk patients with advanced renal cell carcinoma.

According to results of a phase I/II study, men with metastatic castration-resistant prostate cancer who received a second course of radium-223 (Xofigo) experienced minimal hematologic toxicity and low radiographic bone progression rates.

Sunitinib (Sutent) has been granted FDA approval for the adjuvant treatment of patients with renal cell carcinoma (RCC) who have received nephrectomy and are high risk for recurrence.

Matthew D. Galsky, MD, Professor of Medicine, Mount Sinai School of Medicine, discusses progression in patients with metastatic bladder cancer.

In an effort to improve bladder preservation and quality of life, investigators are currently exploring the efficacy of risk-adapted treatment for patients with muscle-invasive bladder cancer after receiving a neoadjuvant accelerated methotrexate, vinblastine, doxorubicin, and cisplatin (MVAC) regimen.

The use of atezolizumab (Tecentriq) is being recommended by the UK's National Institute for Health and Care Excellence (NICE) for treatment-naïve patients with locally advanced or metastatic urothelial carcinoma who are not eligible for cisplatin-based therapy.

Combining the PD-1 inhibitor nivolumab (Opdivo) with the novel IDO inhibitor BMS-986205 generated promising response rates in patients with advanced cervical or bladder cancers and similar adverse effects to what is seen with anti–PD-1 monotherapy, according to findings of an early-phase clinical trial presented by Jason J. Luke, MD, during the SITC 32nd Annual Meeting.