ESMO 2023

(UroToday.com)The 2023 European Society of Medical Oncology (ESMO) Annual Congress held in Madrid, Spain between October 20th and 24th, 2023 was host to a neoadjuvant and adjuvant therapy in genitourinary cancers session. Dr. Fabio Schutz discussed global access consideration in the systemic treatment of genitourinary cancers.

(UroToday.com) The 2023 European Society of Medical Oncology (ESMO) Annual Congress held in Madrid, Spain between October 20^th and 24^th, 2023 was host to a neoadjuvant and adjuvant therapy in genitourinary cancers session. Dr. Maria De Santis delivered a state-of-the-art lecture discussing the current state of adjuvant therapy for urothelial carcinoma.

(UroToday.com) The 2023 European Society of Medical Oncology (ESMO) Annual Congress held in Madrid, Spain between October 20^th and 24^th, 2023 was host to a neoadjuvant and adjuvant therapy in genitourinary cancers session. Dr. Srikala Sridhar discussed the current state of perioperative trial designs and endpoints.

(UroToday.com) The 2023 ESMO annual meeting included a session on management of (very) high-risk localized prostate cancer, featuring a presentation by Dr. Derya Tilki discussing the delineation of staging pelvic lymph node dissection before radiotherapy and positioning primary prostatectomy. Dr. Tilki started her presentation by discussing positioning primary radical prostatectomy in patients with high risk prostate cancer. Previous work has noted that not all grade 5 prostate cancer on biopsy is created equal: patients with primary histological Gleason pattern 5 have worse oncological outcomes compared to patients with secondary biopsy Gleason pattern 5 disease.

(UroToday.com) The 2023 European Society of Medical Oncology (ESMO) Annual Congress held in Madrid, Spain between October 20^th and 24^th, 2023 was host to a neoadjuvant and adjuvant therapy in genitourinary cancers session. Dr. Guillermo Antonio De Velasco Oria de Rueda delivered a state-of-the-art lecture discussing the current state of adjuvant therapy for renal cell carcinoma (RCC).

(UroToday.com) The 2023 ESMO annual meeting included a session on the management of (very) high-risk localized prostate cancer, featuring a presentation by Dr. Gwenaëlle Gravis discussing how much and how long we should be giving systemic treatment. Dr. Gravis started by summarizing the current available literature for neoadjuvant treatments with radical prostatectomy for high risk prostate cancer, which to date has not been impressive:

(UroToday.com)The 2023 ESMO annual meeting included a session on management of (very) high-risk localized prostate cancer, featuring a presentation by Dr. Alberto Bossi discussing dose intensification and field expansion of External Beam Radiation Therapy (EBRT). Dr. Bossi started by noting that high risk patients are the ideal candidates for selective intra-prostatic dose intensification:

(UroToday.com) The 2023 European Society of Medical Oncology (ESMO) Annual Congress held in Madrid, Spain between October 20^th and 24^th, 2023 was host to a ‘Dissecting metastatic castration-sensitive prostate cancer (mCSPC) for optimal patient benefit’ session. Dr. Alicia Morgans discussed the tolerance and long-term side effects of medical treatment of patients in the mCSPC disease space.

(UroToday.com) The 2023 ESMO annual meeting included a session on management of (very) high-risk localized prostate cancer, featuring a presentation by Dr. Karolien Goffin discussing usefulness and limitations of PSMA imaging/PET in high-risk localized disease. Dr. Goffin started her presentation by emphasizing that there are several key points to keep in mind when considering PSMA PET in high-risk localized disease, including: (i) sensitivity, (ii) specificity, (iii) impact, (iv) outcome (v) patient comfort, (vi) cost, and (vii) mSv

(UroToday.com) The 2023 ESMO annual meeting included a session on prostate cancer, featuring a presentation by Dr. Andre Fay discussing patient reported outcomes in the phase 3 TALAPRO-2 study. TALAPRO-2 showed statistically significant improvement in imaging-based progression-free survival with talazoparib + enzalutamide (n = 200) vs placebo + enzalutamide (n = 199) (HR 0.45, 95% CI 0.33–0.61) in men with HRR mutations receiving first-line treatment for mCRPC.¹ However, the impact of treatment on patient health related quality of life is important to consider along with potential clinical benefits, as maintaining or improving quality of life is a major goal of treatment for mCRPC. At the 2023 ESMO annual congress, Dr. Fay and colleagues reported patient-reported outcomes data for this HRR mutation cohort.

(UroToday.com) The 2023 ESMO annual meeting included a session on prostate cancer, featuring a presentation by Dr. Mikaela Dell'Oro discussing the application of novel machine learning model in ⁶⁸Ga-PSMA-11 PET/CT. Biochemical recurrence is estimated to occur in ≥ 25% of patients with prostate cancer following primary curative therapy.

(UroToday.com) The 2023 ESMO annual meeting included a session on prostate cancer, featuring a presentation by Dr. John Shen discussing results from APEX-01, a first-in-human phase 1/2 study of ARX517, an anti-PSMA antibody-drug conjugate, in patients with metastatic castration-resistant prostate cancer (mCRPC). Previous PSMA-targeted antibody drug conjugates demonstrated early clinical efficacy, but drug development was discontinued due to intolerable toxicities, resulting from premature release and off-target delivery of the cytotoxic payload. ARX517 is a novel antibody-drug conjugate composed of a fully humanized anti-PSMA monoclonal antibody conjugated to amberstatin-269, a potent tubulin inhibitor:

(UroToday.com) The 2023 ESMO annual meeting included a session on prostate cancer, featuring a presentation by Dr. Nishita Tripathi discussing the impact of intensified ADT in the metastatic castration-sensitive prostate cancer (mCSPC) setting on metastatic castration-resistant prostate cancer (mCRPC) disease characteristics and survival outcomes. ADT intensification is the standard of care treatment for mCSPC.

(UroToday.com) The 2023 European Society of Medical Oncology (ESMO) Annual Congress held in Madrid, Spain between October 20^th and 24^th, 2023 was host to a ‘Dissecting metastatic castration-sensitive prostate cancer (mCSPC) for optimal patient benefit’ session. Dr. Gerhardt Attard discussed how best to integrate biology into the treatment of mCSPC patients.

(UroToday.com) The 2023 ESMO annual meeting included a session on prostate cancer, featuring a presentation by Dr. Nobuaki Matsubara discussing subgroup analyses of the all-comers cohort from TALAPRO-2 by HRR status. Co-inhibition of the AR and PARP may result in enhanced benefit in the treatment of prostate cancer, regardless of alterations in DNA damage response genes involved either directly or indirectly in Homologous Recombination Repair (HRR).

(UroToday.com) The 2023 ESMO annual meeting included a session on prostate cancer, featuring a presentation by Dr. Steven Yip discussing germline vs somatic origin of Homologous Recombination Repair (HRR) gene alterations and potential associations with antitumor activity in the HRR-deficient population from TALAPRO-2.

The 2023 ESMO annual meeting included a session on prostate cancer, featuring a presentation by Dr. Steven M. Yip discussing real world treatment patterns of metastatic prostate cancer with enhanced access to HRR genomic testing and PARP inhibitors. An estimated 25% of individuals with metastatic castration-resistant prostate cancer(mCRPC) diagnosis possess either germline or somatic alterations in the DNA damage repair genomic pathway, which may have an impact on prognosis and treatment, as well as familial screening of family members.

(UroToday.com) The 2023 ESMO annual meeting included a session on kidney cancer, featuring a presentation by Dr. Georges Gebrael discussing comparative effectiveness of second line treatment with cabozantinib in patients with metastatic clear cell RCC after first line treatment with ipilimumab + nivolumab versus PD-1/L1 inhibitor + TKI. Based on the NCCN guidelines, the preferred first line treatment for patients with metastatic clear cell RCC is either ipilimumab + nivolumab or PD inhibitor + TKI. However, cabozantinib was approved based on phase 3 METEOR trial¹ results from patients after prior metastatic clear cell RCC progression on 1-2 TKIs but not PD inhibitor treatment. In the real world, cabozantinib is the most used second line therapy but its effectiveness after prior PD inhibitor based combination is unknown.

(UroToday.com) The 2023 ESMO annual meeting included a session on prostate cancer, featuring a presentation by Dr. Gerhardt Attard discussing the efficacy of niraparib and abiraterone acetate + prednisone in HRR gene-altered metastatic castration-resistant prostate cancer (mCRPC) by tissue and/or plasma assays in the MAGNITUDE trial.¹

(UroToday.com) The 2023 ESMO annual meeting included a Presidential session, featuring a discussant presentation by Dr. Christopher Sweeney discussing the PSMAfore phase 3 trial. Dr. Sweeney started by highlighting that there are several clear strengths of the PSMAfore trial: