GENITOURINARY CANCERS

Therapeutic Management of Nonmetastatic Prostate Cancer

Therapeutic Approach for Nonmetastatic Prostate Cancer

The PD-L1 inhibitor avelumab (Bavencio) has been granted a breakthrough therapy designation by the FDA for use in combination with the VEGF inhibitor axitinib (Inlyta) in treatment-naïve patients with advanced renal cell carcinoma.

Based on data from the phase III SPARTAN trial, apalutamide has been granted a priority review by the FDA for the treatment of patients with nonmetastatic castration-resistant prostate cancer, according to Janssen Biotech, the manufacturer of the next-generation oral androgen receptor inhibitor.

Based on results of the CABOSUN trial, cabozantinib (Cabometyx) has been approved by the FDA for previously untreated patients with advanced renal cell carcinoma.

Based on findings of the phase III CheckMate-214 trial, a supplemental biologics license application for the combination of nivolumab and ipilimumab has been granted a priority review by the FDA as a frontline treatment for intermediate- and poor-risk patients with advanced renal cell carcinoma.

According to results of a phase I/II study, men with metastatic castration-resistant prostate cancer who received a second course of radium-223 (Xofigo) experienced minimal hematologic toxicity and low radiographic bone progression rates.

Sunitinib (Sutent) has been granted FDA approval for the adjuvant treatment of patients with renal cell carcinoma (RCC) who have received nephrectomy and are high risk for recurrence.

Matthew D. Galsky, MD, Professor of Medicine, Mount Sinai School of Medicine, discusses progression in patients with metastatic bladder cancer.

In an effort to improve bladder preservation and quality of life, investigators are currently exploring the efficacy of risk-adapted treatment for patients with muscle-invasive bladder cancer after receiving a neoadjuvant accelerated methotrexate, vinblastine, doxorubicin, and cisplatin (MVAC) regimen.

The use of atezolizumab (Tecentriq) is being recommended by the UK's National Institute for Health and Care Excellence (NICE) for treatment-naïve patients with locally advanced or metastatic urothelial carcinoma who are not eligible for cisplatin-based therapy.

Combining the PD-1 inhibitor nivolumab (Opdivo) with the novel IDO inhibitor BMS-986205 generated promising response rates in patients with advanced cervical or bladder cancers and similar adverse effects to what is seen with anti–PD-1 monotherapy, according to findings of an early-phase clinical trial presented by Jason J. Luke, MD, during the SITC 32nd Annual Meeting.

Metastatic urothelial cancer is a relatively chemotherapy-sensitive malignancy. With contemporary cisplatin-based combination chemotherapy regimens, objective responses are achieved in approximately 50-60% of patients and complete radiographic responses are achieved in approximately 10-20% of patients.

For decades and even to this day, the foundation of metastatic bladder cancer therapy has been cytotoxic chemotherapy. In fact, until recently, the most significant breakthrough in treatment was in the 1980s, when cisplatin-based therapies, specifically MVAC, became the new standard of care.

In an interview, Jonathan E. Rosenberg, MD, discusses the guidelines and their significance for the treatment of patients with muscle-invasive bladder cancer.

A multidisciplinary set of guidelines for the treatment of patients with nonmetastatic muscle-invasive bladder cancer has been created as a result of a new collaboration between the American Urological Association and several other prominent urological groups. The new guidelines provide a risk-stratified clinical framework to better diagnose, treat, and manage the disease. 

Janssen Biotech has submitted a new drug application to the FDA for apalutamide (ARN-509) for the treatment of non-metastatic castration-resistant prostate cancer, the manufacturer of the next-generation oral androgen receptor inhibitor announced today.

According to an update from the phase II KEYNOTE-052 trial presented at the 2017 Global Congress on Bladder Cancer, pembrolizumab (Keytruda) was safe and provided tumor reduction as well as durable responses as a first-line treatment for patients with cisplatin-ineligible advanced urothelial cancer.

The therapeutic landscape for patients with metastatic urothelial carcinoma is being rapidly altered by clinical trials of immunotherapy, but overall survival could be dramatically improved simply by changing the way quality of life is monitored, according to findings presented at the 2017 Global Congress on Bladder Cancer.