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PEER-TO-PEER CLINICAL CONVERSATIONS |
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Bridging Evidence to Practice: Bladder Cancer Therapy Guidelines and Global Implementation
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Andrea Apolo, MD
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| Ashish Kamat talks with Andrea Apolo about implementing new treatment standards in bladder cancer, focusing on the recent EV-302 and CheckMate-901 trials. Dr. Apolo explains how enfortumab vedotin plus pembrolizumab has emerged as the new standard of care for metastatic urothelial carcinoma, showing superior survival outcomes compared to traditional platinum-based chemotherapy.
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| EV-302 Trial Results: A New Standard in Metastatic Urothelial Carcinoma |
| Daniel Petrylak, MD |
| David Crawford discusses advancements in advanced urothelial cancer treatment with Daniel Petrylak. Dr. Petrylak highlights the success of enfortumab vedotin, an antibody-drug conjugate targeting nectin-4, combined with pembrolizumab. |
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| Bladder Cancer Breakthroughs in SunRISe-1, AMBASSADOR, and VOLGA Trials |
| Maria De Santis, MD, PhD |
| Alicia Morgans interviews Maria De Santis about three studies: the SunRISe-1 trial for non-muscle-invasive bladder cancer, the AMBASSADOR study on adjuvant pembrolizumab for muscle-invasive urothelial carcinoma, and the VOLGA trial exploring ctDNA clearance as a biomarker. |
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| Disrupting the Paradigm of First-line Therapy in Metastatic Urothelial Cancer
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| Andrea B. Apolo, MD
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| The BCAN 2024 Think Tank highlighted new phase III trials revolutionizing first-line treatment for metastatic urothelial cancer. Dr. Andrea Apolo discussed the EV-302 trial, where enfortumab vedotin plus pembrolizumab nearly doubled overall survival compared to chemotherapy, and the CheckMate 901 trial, which showed improved survival with nivolumab plus gemcitabine/cisplatin. These trials mark significant advancements, with enfortumab vedotin + pembrolizumab now becoming the new standard of care for this patient population.4o
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| Tailoring Treatment and Navigating Patient Preferences |
| Samuel U. Takvorian, MD, MS |
| Samuel Takvorian highlights that immune-enhancing nutrition did not improve post-operative outcomes in radical cystectomy patients, though future research may explore its role in immunotherapy. Enfortumab vedotin + pembrolizumab was shown to improve progression-free survival with minimal impact on overall quality of life, while dose modifications maintained the drug's effectiveness, offering a balance between efficacy and managing side effects. |
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| Health-Related Quality of Life from the CheckMate 901 Trial of Nivolumab as First-Line Therapy for Unresectable or Metastatic Urothelial Carcinoma |
| Jens Bedke, MD |
| Jens Bedke presented an exploratory analysis from the CheckMate 901 trial, evaluating health-related quality of life (HRQoL) for patients receiving nivolumab plus gemcitabine/cisplatin (GC) versus GC alone as first-line therapy for unresectable or metastatic urothelial carcinoma. The analysis showed noninferiority of nivolumab + GC in maintaining global health status and quality of life, with no significant deterioration compared to GC alone. |
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| Nivolumab plus Chemoradiotherapy in Patients with Non-Metastatic Muscle-Invasive Bladder Cancer, Not Undergoing Cystectomy: A Phase II, Randomized Study by the Hellenic GU Cancer Group |
| Andromachi Kougioumtzopoulou MD |
| Andromachi Kougioumtzopoulou presents a phase II study on nivolumab plus chemoradiotherapy in patients with non-metastatic MIBC who did not undergo cystectomy. The study found that the addition of nivolumab significantly improved bladder cancer failure-free survival and 2-year overall survival compared to chemoradiotherapy alone, with no new safety concerns. These results support further trials to establish nivolumab plus TMT as a potential standard treatment for MIBC patients avoiding cystectomy. |
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| Randomized Phase 3 Trial of Neoadjuvant Durvalumab plus Chemotherapy Followed by Radical Cystectomy and Adjuvant Durvalumab in Muscle-Invasive Bladder Cancer (NIAGARA) |
| Thomas B. Powles, MBBS, MRCP, MD |
| The NIAGARA trial, presented by Thomas B. Powles at the 2024 ESMO Congress, investigated the efficacy of neoadjuvant Durvalumab combined with chemotherapy in muscle-invasive bladder cancer (MIBC). This randomized Phase 3 trial is notable for being the largest ever conducted in this field and aims to improve outcomes for cisplatin-eligible patients. |
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| Identification of Bladder Cancer Patients That Could Benefit from Early Post-Cystectomy Immunotherapy Based on Serial Circulating Tumour DNA Testing: Preliminary Results from the TOMBOLA Trial |
| Jørgen Bjerggaard Jensen, MD |
| Jørgen Bjerggaard Jensen presents preliminary findings from the TOMBOLA trial, which explored the use of serial circulating tumor DNA testing to identify bladder cancer patients who might benefit from early post-cystectomy immunotherapy. The study showed that 56% of patients had a positive ctDNA status after radical cystectomy, and those who converted to ctDNA-negative status demonstrated significant potential for complete response, indicating that ctDNA testing could help tailor immunotherapy treatments and avoid overtreatment in high-risk patients. |
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