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PEER-TO-PEER CLINICAL CONVERSATIONS |
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Lessons Learned from Other Cancers that Can be Applied to Bladder Cancer
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Petros Grivas, MD, PhD
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| Shilpa Gupta and Petros Grivas engage in a discussion about lessons learned from immunotherapy use across different cancer types and their application to urothelial cancer. The conversation explores contrasting approaches between kidney cancer, where immunotherapy rechallenge after progression shows no benefit, and melanoma, where immunotherapy rechallenge remains acceptable.
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| Real-World Effectiveness of Enfortumab Vedotin in Advanced Urothelial Carcinoma |
| Umang Swami, MD |
| Alicia Morgans speaks with Umang Swami about a publication in Clinical Genitourinary Cancer examining the real-world effectiveness of enfortumab vedotin (EV) in advanced urothelial carcinoma. |
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| Combination Maintenance Therapy for Advanced Bladder Cancer Explored in MAIN-CAV Study |
Shilpa Gupta, MD
Shilpa Gupta discusses the challenges and progress of the MAIN-CAV study examining the combination of treatments for urothelial cancer in the U.S., impacted by a platinum drug shortage. Despite setbacks, efforts are underway to increase patient enrollment, with assistance from Canadian colleagues. |
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| International Panel Defines Endpoints and Control Arms for Trials in Locally Advanced and Metastatic Bladder Cancer - Journal Club |
Rashid Sayyid, MD, MSc and Zachary Klaassen, MD, MSc
Rashid Sayyid and Zach Klaassen discuss recommendations from the Society for Immunotherapy of Cancer and the International Bladder Cancer Group on clinical trial designs for bladder cancer. |
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| Economic Burden of Radical Cystectomy and Trimodal Therapy for Bladder Cancer in the United States: Real-World Study |
| Stephen Williams, MD, MBA, MS, FACS, FACHE |
| A real-world analysis presented at ASCO GU 2024 examined the economic burden of radical cystectomy (RC) and trimodal therapy (TMT) for muscle-invasive bladder cancer using claims data. RC had high initial inpatient costs ($70,671 at 3 months), while TMT had lower upfront costs but higher long-term outpatient expenses ($274,462 at 5 years). |
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| Avelumab First-Line Maintenance for Advanced Urothelial Carcinoma: Long-Term Outcomes from the JAVELIN Bladder 100 Trial in Patients with Histological Subtypes
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| Yohann Loriot, MD, PhD
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| A post hoc analysis of the JAVELIN Bladder 100 trial presented at ASCO 2024 evaluated the long-term efficacy and safety of avelumab first-line maintenance in advanced urothelial carcinoma patients with histological subtypes. Results showed improved overall survival (HR 0.74) and progression-free survival (HR 0.52) with avelumab + best supportive care versus supportive care alone, with no new safety concerns.
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| Enfortumab Vedotin plus Pembrolizumab in the Treatment of Locally Advanced or Metastatic Bladder Cancer of Variant Histology: A Phase II Study |
| Bassel Nazha, MD, MPH |
| Bassel Nazha presents a phase II trial evaluating enfortumab vedotin plus pembrolizumab for locally advanced or metastatic bladder cancer of variant histology, a population underrepresented in prior trials. This open-label study at Emory University aims to assess objective response rates, with secondary endpoints including survival, safety, and quality of life. |
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| Study EV-103: Neoadjuvant Treatment with Enfortumab Vedotin Monotherapy in Cisplatin-Ineligible Patients with Muscle-Invasive Bladder Cancer (MIBC) 2-Year Event-Free Survival and Safety Data for Cohort H
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| Peter O'Donnell, MD
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| Peter O'Donnell presented 2-year event-free survival and safety data from the EV-103 study (Cohort H) at ASCO 2024, evaluating enfortumab vedotin as neoadjuvant therapy in cisplatin-ineligible muscle-invasive bladder cancer (MIBC). The study reported a 2-year EFS of 62%, a pathological complete response rate of 36.4%, and a manageable safety profile. All patients successfully underwent surgery without delays due to treatment-related adverse events.
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| HER2 and PD-L1 Immunohistochemistry Expression, and HER2 Genomic Alterations: Associations and Clinical Outcomes for Advanced Bladder Cancer |
| David Aggen, MD, PhD |
| David Aggen presents data on the prevalence of HER2 alterations and its relationship with PD-L1 expression in advanced bladder cancer. The study found that 22.3% of bladder cancer samples had HER2 alterations. While high-level HER2 expression (2+/3+) was observed in 52% of tumors, it was not strongly linked to progression-free survival or overall survival in muscle-invasive bladder cancer. A significant inverse correlation was found between PD-L1 and HER2 expression. |
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