GU Experts Share Key Takeaways From 2020 Genitourinary Cancers Symposium

At the 2020 Genitourinary Cancers Symposium, OncLive^® asked key opinion leaders in the field to share what they considered to be the greatest takeaways from the meeting and provide insight on where treatment is headed in their respective areas of expertise.

Toni K. Choueiri, MD, Director, Lank Center for Genitourinary Oncology; Director, Kidney Cancer Center; Senior Physician, Dana-Farber Cancer Institute; and Jerome and Nancy Kohlberg Chair and Professor of Medicine, Harvard Medical School

Toni K. Choueiri, MD

Toni Choueiri, MD: Director, Lank Center for Genitourinary Oncology; Director, Kidney Cancer Center; Senior Physician, Dana-Farber Cancer Institute; and Jerome and Nancy Kohlberg Chair and Professor of Medicine, Harvard Medical School

“It was another rich symposium; [we saw] many translational studies in prostate cancer and bladder cancer. There were also quite interesting quality-of-life data, which [could be] practice-changing—especially when patients and physicians have many options [to consider].

Aside from that, in kidney cancer, some interesting [research] looked at cytoreductive nephrectomy in the immunotherapy era, although this was not a prospective clinical trial; these were results from the International Metastatic RCC Database. We should take [these findings with] a grain of salt, but [nonetheless] this was interesting work that I have been involved with.

Another exciting study examined the use of the TKI sitravatinib in combination with nivolumab (Opdivo) post-TKI failure [in patients with advanced clear cell renal cell carcinoma (RCC)]; that [regimen] showed some promising activity. In another study, [investigators examined] lenvatinib (Lenvima) and everolimus (Afinitor) in a hard-to-treat population of non-clear cell RCC. It [induced] a 25% [objective] response rate, with some responses [observed] in a small number of patients with chromophobe RCC, which is a particularly difficult-to-treat tumor. This was quite an intriguing meeting [and it was nice] to enjoy all the data in the city of San Francisco, California.

Rana R. McKay, MD, Medical Oncologist, Urologic Cancer Unit, University of California (UC), San Diego Healths Moores Cancer Center; Assistant Professor, Department of Medicine at UC San Diego School of Medicine

Rana R. McKay, MD

Rana R. McKay, MD: Medical Oncologist, Urologic Cancer Unit, University of California (UC), San Diego Health’s Moores Cancer Center; Assistant Professor, Department of Medicine at UC San Diego School of Medicine

“With regard to where the field is headed with prostate cancer, if we hear “Prostate membrane antigen (PSMA)” 1 more time we are all going to go crazy. [I believe that] PSMA imaging and PSMA-targeted therapies are really [what’s next for] the field.

Everyone is anticipating the results of the VISION trial, which is examining the use of lutetium-177 PSMA-617 in patients with advanced prostate cancer; that [research] has the potential to have a profound impact with regard to metastatic castration-resistant prostate cancer and treatment for those individuals.

We also saw quality-of-life (QoL) data from the STAMPEDE trial, which is examining [the addition of up-front] abiraterone acetate (Zytiga) or docetaxel given [to androgen deprivation therapy]. It was very interesting to see those patient-reported QoL analyses performed. [Now that] we are making our patients live longer, [we’re starting to ask ourselves], “How we can help them live better?” This is a huge message and takeaway [from the meeting].”

Jonathan E. Rosenberg, MD, Medical Oncologist; Chief, Genitourinary Medical Oncology Service, Division of Solid Tumor Oncology; Enno W. Ercklentz Chair, Memorial Sloan Kettering Cancer Center

Jonathan E. Rosenberg, MD

Jonathan E. Rosenberg, MD: Medical Oncologist; Chief, Genitourinary Medical Oncology Service, Division of Solid Tumor Oncology; Enno W. Ercklentz Chair, Memorial Sloan Kettering Cancer Center

“There’s a lot of exciting work going on in non-muscle invasive bladder cancer that I believe will change how we treat our patients and [may provide them with] many more options. We recently saw the FDA approval of pembrolizumab (Keytruda). We’ve also seen positive results reported at this meeting with non-muscle invasive immunotherapy approaches; I believe that’s a very big change, and we’ll see more change as time goes on [and we learn more about that].

In addition, there has been some interest in [examining] different strategies with chemotherapy as well as [approaching patient selection], based on either biomarkers or clinical factors [and] that will all change how we think about treating our patients.

Fortunately, in bladder cancer, we’re moving beyond just platinum-based chemotherapy as the mainstay of all of our therapy in the disease. [Now, we’re exploring] immunotherapy and targeted therapy with erdafitinib (Balversa). Other FGFR inhibitors are also being tested, and now [we also have] enfortumab vedotin-ejfv (Padcev), which is really a first-in-class [antibody-drug conjugate. It has a] new target and [it is a] new drug that was first deployed in bladder cancer.”

Sumanta K. Pal, MD, Medical Oncologist; Associate Clinical Professor, Department of Medical Oncology & Therapeutics Research; Co-director, Kidney Cancer Program, City of Hope

Sumanta K. Pal, MD

Sumanta K. Pal, MD: Medical Oncologist; Associate Clinical Professor, Department of Medical Oncology & Therapeutics Research; Co-director, Kidney Cancer Program, City of Hope

“At the 2020 Genitourinary Cancers Symposium, combination therapy seems to be a prevailing theme. For instance, in bladder cancer, there is a combination of enfortumab vedotin with pembrolizumab with really outstanding response rates with that particular combination. In addition, we reported out the data for cabozantinib (Cabometyx) and atezolizumab (Tecentriq) in the context of COSMIC-021 in prostate cancer. While we spent a lot of time developing these agents individually, we are going to see that we offer maximal benefit to patients through offering a combination of therapies.”