Two Landmark Conferences Contribute to Progress in Kidney and Bladder Cancers

Mike Hennessy, Chairman & CEO

The tail-end of this year saw 2 annual conferences occurring at the same time: the 2016 Large Urology Group Practice Association (LUGPA) annual meeting in Chicago, and the 15th annual International Kidney Cancer Symposium (IKCS) in Miami. Both are covered in this issue’s Conference Highlights section, featuring key stories and landmark research in their respective fields.

From the LUGPA meeting, we focus on emerging therapies and diagnostic tools for bladder cancer. Geoffrey Sklar, MD, met with Urologists in Cancer Care for an interview on the potential for neoadjuvant immunotherapy in bladder cancer. The current focus is on PD-L1 inhibitors, but we still don’t have effective therapies for high-grade, non-muscle invasive bladder cancer (NMIBC). Nivolumab is showing a lot of promise for patients with advanced disease, but immunotherapy tends to work best with low-volume disease and earlier intervention, says Sklar, and there are areas that need “major improvement.”

In response to this call for improvement, there are novel immunotherapies being offered for NMIBC. Several studies have been conducted, and more are on the way, with researchers looking into intravesical gene therapy and various drug combinations.

Of course, there is no substitute for early detection, accurate diagnosis, and effective monitoring. Bladder cancer biomarkers could be essential to bringing beneficial care and improving tumor detection. In particular, new assays like the BTA/BTA Stat, NMP22 (BladderChek), UroVysion’s post-BCG FISH test, ImmunoCyt, and Cxbladder are emerging to accomplish these very goals. We discuss the benefits and drawbacks of these tests, with valuable input from Badrinath Konety, MD, MBA.

Several treatments options are on the rise for kidney cancer. In an interview with Toni K. Choueiri, MD, it becomes clear that no single therapy can be the end-all, be-all in treating renal cell carcinoma (RCC), but instead, combination therapies and targeted agents make better treatment options. Choueiri points specifically to the MET inhibitor volitinib, which is undergoing study in a phase II trial, as a promising treatment option alongside other MET inhibitors and recently approved drugs.

However, immunotherapy is still considered by experts to be integral to optimizing adjuvant care. In fact, an expert panel that gathered at IKCS projected that immunotherapy will be critical to optimizing outcomes in the adjuvant setting for patients with RCC. More pointedly, the panelists agreed upon the importance of investigating prognostic markers in order to prevent overtreatment or incorrect treatment of RCC, which is a rising issue of the last few years.

And finally, lenvantinib and everolimus combination regimens are emerging as essential second-line treatment options in advanced RCC, and research to move the regimen into frontline settings is underway. Thomas E. Hutson, DO, PharmD, strongly advocates for this combination, discussing its unique success in Study 205. All these stories sum up to a hopeful future, with much progress to come.