Thematic session highlights hot onco-urology updates
Conclusions from recent oncology meetings were summarised during “Thematic Session 11: Latest and hot news in medical treatment in onco-urology”, which was chaired by Prof. Francesco Montorsi (IT) and Prof. Manfred Wirth (DE).
Prof. Paul Nguyen (US) provided updates and status regarding agents that improve overall survival in M1 hormone-sensitive prostate cancer (HSPC). The overall and high-volume benefits of docetaxel (doce) are known. Also for abiraterone (abi), all benefits are determined. With regard to radiation (XRT), the low-volume benefits are identified. For the surgery benefits, results of the SWOG 1802 study are awaited. Results from the ARCHES and ENZAMET trials will provide more information on Enzalutamide benefits, and for abi/XRT to doce/ADT, the results from the PEACE-1 trial. For apalutamide, the overall benefits are known and results from the TITAN trial for the high- and low-volume benefits are to come. The results from the ARASENS trial will provide more insights on Darolutamide benefits. “We have a clearer picture based on charted volume and overall effects,” said Prof. Nguyen.
Prof. Christopher Evans (US) addressed questions on castration-resistant prostate cancer (CRPC) from last year. Regarding the ERA223 study (abi plus Radium-223 for metastatic CRPC), concurrent treatment with abiraterone and prednisone (AAP) + Radium-223 did not improve SSE-free survival (SSE-FS) or overall survival with AAP + Placebo in men with metastatic CRPC (mCRPC). Clinical fractures were more common in the AAP + Radium-223 group.
On cabazitaxel versus abi or enzalutamide in poor prognosis mCRPC, there was a higher clinical benefit rate for cabazitaxel vs. abi/enzalutamide. Baseline and on-treatment change in circulating tumour DNA (ctDNA) fraction was prognostic. Individual genomic alterations were not predictive for treatment benefit.
“Real-world atezolizumab data is reassuring,” said Prof. Dr. Thomas Powles (GB) during his lecture on urothelial cancer. He added that immune therapy in the frontline cisplatin is restricted to the PD-L1 population, and he urges to test the biomarker.
Prof. Powles stated that atezolizumab and prembrolizumab have impressive activity earlier in the disease. He asserted that new targets, Erdafitinib and Enfortumab Vedotin, hold promise.
In his presentation on renal cell carcinoma, Prof. Axel Merseburger (DE) said that to improve outcome, use IO-Therapy (PD1/PDL 1 pathway blockers) combinations. He said to await developments on upcoming trial Phase III Checkmate 9ER trial, “A Study of Nivolumab Combined With Cabozantinib Compared to Sunitinib in Previously Untreated Advanced or Metastatic Renal Cell Carcinoma” and the CLEAR study (Len+Pembro). He advised to take oncologic outcomes, costs, toxicity, and the Guidelines into account.
Although there are no current updates on testis and penile cancer, Dr. Jan Oldenburg (NO) emphasised the importance of centralization and to have patients treated in experienced hospitals. He advised to adhere to the Guidelines include patients into clinical trials whenever possible.