{"id":5464,"date":"2023-06-06T08:59:27","date_gmt":"2023-06-06T08:59:27","guid":{"rendered":"https:\/\/aceoncology.org\/?p=5464"},"modified":"2023-06-06T08:59:28","modified_gmt":"2023-06-06T08:59:28","slug":"asco-2023-gu-cancers-symposium-pt2","status":"publish","type":"post","link":"https:\/\/aceoncology.org\/zh-hans\/asco-2023-gu-cancers-symposium-pt2\/","title":{"rendered":"Highlights from the ASCO 2023 GU Cancers Symposium, Part 2\u00a0"},"content":{"rendered":"\n

The American Society of Clinical Oncology (ASCO) recently held its 2023 Genitourinary Cancers Symposium<\/u><\/a> in San Francisco, California. The meeting focused on multidisciplinary approaches in GU cancer treatment, research, and care. Previously<\/u><\/a>, the latest data in first-line treatments for locally advanced or metastatic urothelial carcinoma were discussed. Herein are new data in adjuvant therapy for high-risk non-muscle-invasive bladder cancer (NMIBC) and localized muscle-invasive urothelial carcinoma (MIUC).<\/p>\n\n\n\n

High-Risk Non-Muscle-Invasive Bladder Cancer <\/strong><\/strong><\/p>\n\n\n\n

Current standard of care for high-risk NMIBC is transurethral resection of the bladder tumor (TURBT), followed by therapy with intravesical bacillus Calmette-Guerin (BCG). Patients who do not respond to BCG or who relapse within 12 months of BCG therapy face a poor prognosis and require radical cystectomy. The multicohort phase 2 KEYNOTE-057 trial evaluated pembrolizumab monotherapy in patients with BCG-unresponsive high-risk NMIBC who were ineligible for radical cystectomy. Data from Cohort A<\/u><\/a> (carcinoma in situ [CIS] with or without papillary tumors) from this trial led to the US FDA approval of pembrolizumab in this setting. At ASCO GU 2023, Andrea Necchi, MD (Vita-Salute San Raffaele University, IRCCS San Raffaele Hospital and Scientific Institute, Milan, Italy) presented the data from Cohort B.<\/p>\n\n\n\n

Cohort B<\/u><\/a> consisted of patients with papillary tumors only who had already undergone TURBT before receiving 200 mg of IV pembrolizumab every 3 weeks for up to 2 years. They remained on treatment until disease recurrence or progression. The primary endpoint was 12-month disease-free survival (DFS) and safety. The cohort included 132 patients at 54 sites. At the time of data cutoff, the median follow-up was 45.4 months (range, 14.9 \u2013 77.1). Among the cohort, 83 patients (63%) experienced recurrence, progression, or death in a median of 7.7 months (95% CI: 5.5, 13.6). The 12-month DFS rate was 43.5% (95% CI: 34.9, 51.9). The 24-month and 36-month DFS rates were both 35% (95% CI: 26.4, 43.4).<\/p>\n\n\n\n

The authors concluded that pembrolizumab has a manageable safety profile, with no treatment-related deaths and stable quality of life during treatment. Based on sample size and follow-up duration, these results are among the most robust for a novel systemic therapy for papillary high-risk NMIBC. Data suggest that patients with papillary high-risk NMIBC who did not respond to BCG may benefit from pembrolizumab monotherapy.<\/p>\n\n\n\n

Muscle-Invasive Urothelial Carcinoma<\/strong><\/p>\n\n\n\n

Based on the CheckMate 274<\/u><\/a> trial, adjuvant nivolumab became a standard of care for patients with high-risk MIUC following radical surgery. This phase 3 trial met both of its primary endpoints, increasing DFS in the intention-to-treat population and among patients with a PD-L1 expression level of \u2265 1% when compared with placebo. At ASCO GU 2023, Matthew D. Galsky, MD (Icahn School of Medicine at Mount Sinai, New York, US) presented the extended follow-up results from the CheckMate 274 trial.<\/p>\n\n\n\n

With extended follow-up<\/u><\/a> (median: 36.1 months),the median DFS was doubled with nivolumab compared with placebo in the intention-to-treat population (22.0 vs. 10.9 months; HR, 0.71). The PD-L1 population experienced even greater benefits: median DFS was 52.6 months with nivolumab vs. 8.4 months in the placebo group (HR, 0.52). The data were similar for median non-urothelial tract recurrence-free survival (NUTRFS) in the ITT group: 25.9 months for nivolumab vs. 13.7 months for placebo (HR, 0.72). In the PD-L1 population, the median NUTRFS was 52.6 months for nivolumab vs. 8.4 months for placebo (HR, 0.53).<\/p>\n\n\n\n

In addition to PD-L1 status, nivolumab\u2019s DFS benefit was seen in subgroups defined by age, sex, ECOG performance status, nodal status, and prior cisplatin-based chemotherapy. No new safety signals were identified. Grade 3\u20134 treatment-related adverse events occurred in 18.2% and 7.2% of patients in the nivolumab and placebo arms, consistent with the primary analysis. Upon extended follow-up, CheckMate 274 results further support adjuvant nivolumab as a standard of care for high-risk MIUC following radical resection.<\/p>\n\n\n\n

The discussant, Michiel Van Der Heijden, MD, PhD (Netherlands Cancer Institute, Amsterdam, Netherlands) noted a concern that the DFS curves for the ITT population were converging after the cessation of therapy at 1 year. However, with this extended follow up, he concluded that the curves remain separated and the hazard ratios are stable. The PD-L1-positive subgroup is very convincing despite the lack of overall survival data. In Europe, only the PD-L1-positive subgroup was registered for nivolumab in this setting.<\/p>\n","protected":false},"excerpt":{"rendered":"

The American Society of Clinical Oncology (ASCO) recent […]<\/p>\n","protected":false},"author":719,"featured_media":5465,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-5464","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-article-highlights"],"acf":[],"yoast_head":"\nHighlights from the ASCO 2023 GU Cancers Symposium, Part 2\u00a0 - ACE Oncology<\/title>\n<meta name=\"description\" content=\"ASCO 2023 GU Cancers Symposium: adjuvant therapy in localized disease\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/aceoncology.org\/zh-hans\/asco-2023-gu-cancers-symposium-pt2\/\" \/>\n<meta property=\"og:locale\" content=\"zh_CN\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Highlights from the ASCO 2023 GU Cancers Symposium, Part 2\u00a0 - 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