Genitourinary Oncologists Break Down Data from Lesser-Known Studies at the 2024 ESMO Congress

Chad Tang, MD

The 2024 ESMO Congress, among other oncology meetings of its kind, is jam-packed with timely updates and data readouts for oncology professionals. To ensure you are receiving the timeliest updates—no matter how big or small—genitourinary oncology experts shared their most notable takeaways from lesser-known studies during interviews with OncLive^®.

Chad Tang, MD, The University of Texas MD Anderson Cancer Center

“There are a lot of great studies out there, but I want to highlight a study that one of the trainees at MD Anderson, Adam Grippin, MD, PhD, is doing. It was in a mini oral session and evaluated the effects of COVID-19 vaccination with PD-1 [inhibitor] treatment. What he showed was that the COVID-19 vaccines—which are RNA-based vaccines—stimulate a response to the immune system that seems to potentiate immunotherapy. That’s interesting because these vaccines generally have a safe toxicity profile. They could be an easy way to augment a lot of standard therapies affecting a lot of cancers.”

Guru P. Sonpavde, MD, AdventHealth Medical Group

“I would like to highlight one trial. It is a trial in progress, but it’s an exciting precision adjuvant immunotherapy trial. This is the phase 2 INTerpath-005 trial [NCT06305767], and I was honored to present this as a poster. This is a randomized trial investigating adjuvant pembrolizumab [Keytruda] in high-risk muscle-invasive urothelial carcinoma, combined with either placebo or V940 [mRNA-4157]. V940 is an mRNA construct encoding for up to 34 neoantigens, customized for each patient. The patient’s tumor, as well as their blood, undergo whole exome sequencing and RNA sequencing, followed by applied bioinformatics; this helps identify up to 34 neoantigens. The mRNA for the neoantigens is then injected into the patient.

“V940 is given intramuscularly every 3 weeks for up to approximately 6 months or 9 doses. This is an exciting trial and [was launched] a few months ago in mid-2024. Approximately 200 patients are [expected] to be enrolled. This [research] is exciting because V940 [in combination with pembrolizumab] has already generated positive outcomes in melanoma in the adjuvant, randomized phase 2 [KEYNOTE-942] trial [NCT03897881], and the phase 3 [INTerpath-001] trial [(NCT05933577) investigating this product in melanoma] is ongoing. The objective is to evaluate this V940 construct across many different malignancies, including bladder cancer. [INTerpath-005] is, to me, an exciting trial, given that [information].”

Eric Jonasch, MD, The University of Texas MD Anderson Cancer Center

“The phase 3 TiNivo-2 study [NCT04987203] examined the combination of tivozanib plus nivolumab [Opdivo] vs tivozanib in patients with previously treated renal cell carcinoma [RCC]. This study was negative, which is unfortunate. It is also somewhat biologically uncertain as to why continuing immuno-oncology therapy in the second- and subsequent-line settings in RCC doesn’t seem to provide additional benefit. This is a black box from a biological understanding perspective and [a question] we need to do a lot of work on to better understand.”

Eddy Saad, MD, MSc, Dana-Farber Cancer Institute

“One of the sad points in prostate cancer has been the use of immunotherapy, which [has produced] one failure after another. At the 2024 ESMO Congress, [researchers presented updates from] the phase 3 CONTACT-02 trial [NCT04446117], [which] looked at a combination of immunotherapy in patients with advanced prostate cancer who are hard to treat. This includes [patients with] visceral metastatic disease or soft tissue disease. I believe people should be looking out for that underdog with immunotherapy; maybe we haven’t heard the end of immunotherapy in prostate cancer.”

Jacob E. Berchuck, MD, Winship Cancer Institute of Emory University

“One study worth highlighting from the 2024 ESMO Congress involved Radium-223 [Xofigo], a radioligand therapy in the same class as lutetium Lu 177 vipivotide tetraxetan [Pluvicto; formerly 177Lu-PSMA-617]. With the FDA approval of lutetium Lu 177 vipivotide tetraxetan, Radium-223 has been used less frequently than before because we now have more of a targeted radioligand therapy. However, the phase 3 PEACE-3 clinical trial [NCT02194842] investigated the addition of Radium-223 to enzalutamide [Xtandi] in men with early metastatic castration-resistant prostate cancer [mCRPC]. It showed that the addition of Radium-223 [to enzalutamide] in this setting improved progression-free survival and overall survival [vs enzalutamide alone].

“This, in terms of an underdog study that maybe we weren’t expecting to see, re-raises the question of the role of lutetium Lu 177 vipivotide tetraxetan in men with mCRPC, especially in light of additional radioligand therapies and other therapies that are under clinical investigation right now. I’m interested to see the ongoing data that are coming out around responses to [lutetium Lu 177 vipivotide tetraxetan] following Radium-223 or responses to Radium-223 following lutetium Lu 177 vipivotide tetraxetan. It is an emerging area, as the field evolves, to understand how we can best use all our FDA-approved therapies to maximize good outcomes for patients. The PEACE-3 trial made me rethink how we use Radium-223 in practice for our patients. This is an evolving area that we need to keep an eye on.”