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PEER-TO-PEER CLINICAL CONVERSATIONS |
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| Navigating the Shift to Enfortumab Vedotin and Pembrolizumab in Advanced Urothelial Cancer: Key Considerations for Clinicians |
| Cora N. Sternberg, MD |
| Cora Sternberg discusses the significant advancement in the treatment of urothelial carcinoma, focusing on enfortumab vedotin (EV) in combination with pembrolizumab. |
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| Antibody-Drug Conjugates in Advanced Urothelial Cancer: Current Landscape and Future Directions |
Matthew D. Galsky, MD, FASCO, and Neal Shore, MD, FACS
Ashish Kamat hosts a discussion with Matthew Galsky and Neal Shore on the latest advancements in antibody-drug conjugates for bladder cancer. |
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| Treatment Options for Advanced Urothelial Cancer Post-EV-302 |
Shilpa Gupta, MD, and Karima Oualla, MD, MSc
Pat Hensley discusses first-line systemic therapy selection for advanced urothelial carcinoma with Karima Oualla and Shilpa Gupta. They highlight cisplatin-based chemotherapy as the traditional mainstay but shift focus to the EV-302 trial, which explores enfortumab vedotin (EV) and pembrolizumab (pembro) as a new first-line combination. |
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| Characterization of Complete Responders to Nivolumab + Gemcitabine-Cisplatin vs Gemcitabine-Cisplatin Alone and Patients with Lymph Node–only Metastatic Urothelial Carcinoma from the CheckMate 901 Trial
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| Matt D. Galsky, MD, FASCO
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| Matt Galsky presents a post hoc analysis from the CheckMate 901 trial at ASCO 2024, highlighting the efficacy of nivolumab combined with gemcitabine-cisplatin versus gemcitabine-cisplatin alone in patients with unresectable or metastatic urothelial carcinoma. The analysis showed that 16.8% of patients achieved complete response, with over 50% having lymph node-only metastasis
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| Optimal Treatment Intensity for Frontline Therapy for Advanced Urothelial Cancer: Which Regimen for Which Patient?
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| Pooja Ghatalia, MD
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| Pooja Ghatalia emphasizes enfortumab vedotin + pembrolizumab as the preferred frontline treatment for advanced urothelial cancer due to its significant improvements in overall and progression-free survival compared to traditional chemotherapy. For patients who cannot receive this combination, gemcitabine + cisplatin + nivolumab remains a viable option, with close monitoring and management of treatment-related adverse events being crucial.
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| Impact of Exposure on Outcomes with Enfortumab Vedotin in Patients with Locally Advanced or Metastatic Urothelial Cancer |
| Daniel P. Petrylak, MD |
| Daniel Petrylak discusses the impact of enfortumab vedotin exposure on outcomes in patients with locally advanced or metastatic urothelial cancer. Enfortumab vedotin monotherapy at 1.25 mg/kg 3Q4W has shown a consistent survival benefit and manageable safety profile across multiple trials. Higher dose intensity correlated with better response rates, and dose modifications were common but did not significantly impact the efficacy, allowing patients to manage adverse events while continuing treatment. |
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| Phase 3 Study of Disitamab Vedotin with Pembrolizumab vs Chemotherapy in Patients with Previously Untreated Locally Advanced or Metastatic Urothelial Carcinoma That Expresses HER2 (DV-001) |
| Matt Galsky, MD |
| Matt Galsky presented the DV-001 trial, a phase 3 study evaluating disitamab vedotin plus pembrolizumab versus chemotherapy in patients with previously untreated HER2-expressing locally advanced or metastatic urothelial carcinoma. This trial aims to compare the combination therapy's efficacy with chemotherapy, focusing on progression-free survival and overall survival as primary endpoints, along with secondary measures like objective response rate and quality of life. |
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| Perioperative Sacituzumab Govitecan Alone or in Combination with Pembrolizumab for Patients with Muscle-Invasive Urothelial Bladder Cancer: SURE-01/02 Interim Results |
| Antonio Cigliola, MD |
| Antonio Cigliola presented interim results from the SURE-01/02 trials, which evaluate perioperative sacituzumab govitecan (SG) alone or with pembrolizumab in muscle-invasive urothelial carcinoma patients. The SURE-01 trial, involving cisplatin-ineligible or refusing patients, showed that SG alone achieved a 36.4% pathological complete response rate among those who underwent radical cystectomy. These findings suggest that SG has potential as a preoperative treatment, with some patients opting for a bladder-saving approach showing no disease relapse. |
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| Tailoring Treatment and Navigating Patient Preferences
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| Samuel U. Takvorian, MD, MS
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| Samuel Takvorian discussed the importance of tailoring treatment and navigating patient preferences in urothelial carcinoma, focusing on three key abstracts. The first study showed that immune-enhancing nutrition did not improve post-operative outcomes for patients undergoing radical cystectomy. The second highlighted patient-reported outcomes from a trial of enfortumab vedotin plus pembrolizumab versus chemotherapy, Lastly, Dr. Takvorian discussed the impact of dose modifications on the efficacy of enfortumab vedotin.
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