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Game changing session 5: Insights on PROpel and IMvigor010

Prof. Noel William Clarke (GB) launched Game changing session 5 with his lecture “Exploratory endpoints from PROpel: A Phase III trial of abiraterone + olaparib vs. abiraterone + placebo in 1st line metastatic castration-resistant prostate cancer” wherein he provided the findings of the trial.

The PROpel trial has shown that abiraterone with olaparib produced a statistically significant improvement in rPFS (radiographic progression-free survival) compared with abiraterone with placebo in 1L (1st line) metastatic castration-resistant prostate cancer (mCRPC). Benefits were observed in all preplanned subgroups and irrespective of homologous recombination repair mutation (HRRm) status.

Furthermore, the secondary endpoints support the superiority of the combination of abiraterone with olaparib compared to abiraterone with placebo. The safety profile of abiraterone with olaparib was consistent with the profiles for the individual drugs enabling the majority of patients to remain on treatment.

PROpel is the first phase III study to demonstrate the clinical benefits of abiraterone with olaparib for patients in the 1L mCRPC setting enrolled irrespective of HRRm status.

Discussant and Chair of the Young Academic Urologists, Dr. Juan Gómez Rivas (ES) added that there is data on clinical benefits such as delaying the onset of new metastasis; not limiting the usefulness of the following treatment lines, as well as, not creating cross-resistance or long-term side effects.

In the next presentation “Overall survival (OS) by circulating tumour DNA (ctDNA) status in patients with post-operative muscle-invasive urothelial carcinoma (MIUC) treated with atezolizumab (atezo): update from IMvigor010”, Prof. Jürgen Gschwend (DE) shared that with longer follow-up since the interim analysis, ctDNA-positive status continued to identify patients at high risk of relapse who have improved OS with atezolizumab in contrast to observation. Improved OS was observed regardless of programmed cell death 1 ligand 1 (PD-L1) status; the benefit was more pronounced in PD-L1 IC2/3 versus IC0/1 in this exploratory analysis. Improvements in OS were observed despite a higher proportion of patients in the observation compared to the atezolizumab arm receiving subsequent immunotherapy.

Longitudinal ctDNA testing increased sensitivity for detecting radiographic relapse earlier. In addition, findings are hypothesis generating and require prospective validation before use in clinical practice.

Discussant and ESOU Chair Prof. Morgan Rouprêt (FR) added, “The IMvigor010 trial is currently recruiting. If there is any future for atezolizumab in the field of bladder cancer, it will come from this study. We need to enroll more patients and send them to the open centres. It’s absolutely important to be committed to the research and we will certainly know more in the field of bladder cancer.”

Prof. Lars Dyrskjøt (DK) and Adjunct Secretary General (Science) Prof. Arnulf Stenzl (DE) led Game changing session 5 as Chairs.

(Re)watch the full presentations via the EAU22 On Demand on the Virtual Platform.