Dr. Siefker-Radtke on Unmet Needs in Frontline Urothelial Cancer Treatment

Arlene O. Siefker-Radtke, MD, professor, Department of Genitourinary Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, discusses key therapeutic developments aimed at addressing unmet needs in metastatic urothelial carcinoma (mUC) treatment.

A majority of patients with mUC are elderly or have associated comorbid conditions that could negatively affect their disease state, Siefker-Radtke explains. Additionally, less than half of patients diagnosed with mUC are eligible for cisplatin-based chemotherapy, the current standard of care (SOC).

The FDA approval of immune checkpoint inhibitors (ICIs) for platinum-ineligible patients has helped improve treatment options in the first-line setting, Siefker-Radtke continues. Development of the antibody-drug conjugate (ADC) enfortumab vedotin (Padcev) could also be incredibly promising. This drug has been associated with encouraging overall response rates (ORRs) in the second line, and results from the phase 1B/2 EV-103 trial (NCT03288545) showed that enfortumab vedotin in combination with the ICI pembrolizumab (Keytruda) elicited an ORR in 64.5% of patients with cisplatin-ineligible, locally advanced or metastatic UC.

These data are highly encouraging for clinicians seeking to ameliorate this unmet need through the development of alternative treatment strategies, Siefker-Radtke concludes.