Genitourinary Cancers

The life expectancy of patients with metastatic castrate-resistant prostate cancer has doubled in recent years thanks to a multitude of new therapies, and there are still many more advancements to come.

Mohammed Haseebuddin, MD, a fellow in Urologic Oncology at Fox Chase Cancer Center, discuses why continued research into immunotherapy in clear cell renal cell carcinoma (RCC) is important, particularly in the adjuvant and neoadjuvant settings.

Sumanta Kumar Pal, MD, medical oncologist, assistant clinical professor, Department of Medical Oncology and Therapeutics Research, City of Hope, discusses the challenges with sequencing the therapies available for patients with renal cell carcinoma (RCC). Pal shared this insight in an interview during the 2016 OncLive State of the Science Summit on GU Cancer.

Results from the phase II CheckMate-275 trial demonstrated favorable safety and efficacy with the PD-1 inhibitor nivolumab as a second-line treatment for patients with metastatic urothelial cancer who have progressed on first-line chemotherapy.

First-line pembrolizumab demonstrated significant antitumor activity in cisplatin-ineligible patients with metastatic urothelial cancer.

The treatment paradigm of advanced renal cell carcinoma (RCC) has been rapidly changing. First, the FDA approved the combination of lenvatinib and everolimus in May 2016 as a treatment for patients with advanced RCC following prior antiangiogenic therapy.

​David Nanus, MD, medical oncologist, Weill Cornell Medicine, discusses the impact of atezolizumab for patients with advanced urothelial bladder cancer.

The FDA has granted a priority review designation to nivolumab as a treatment for patients with locally advanced unresectable or metastatic urothelial carcinoma following progression on a platinum-containing therapy.

Pembrolizumab improved survival compared with chemotherapy in previously treated patients with advanced urothelial cancer in the phase III KEYNOTE-045 trial.

Toni K. Choueiri, MD, clinical director, Lank Center for Genitourinary Oncology, director, Kidney Cancer Center, senior physician, Dana-Farber Cancer Institute, discusses some of the ongoing trials evaluating different immunotherapy agents in renal cell carcinoma.

Cabozantinib plus nivolumab demonstrated promising activity in the second-line setting and beyond at all dose levels tested in patients with advanced/refractory genitourinary cancers.

Surgical treatment of patients with non-muscle invasive bladder cancer can be considered a curative option, but the associated risk in comorbid patients is leading researchers to further explore the option of immunotherapy.

Immunotherapy is at the forefront of the burgeoning treatment landscape in renal cell carincoma, according to David McDermott, MD.

Laurence Albiges, MD, ‎medical oncologist, head, Genitourinary Oncology Unit, Gustave Roussy, discusses how immunotherapy has had an impact on the field of renal cell carcinoma (RCC).

In a propensity-matched analysis of a national cancer registry, patients who underwent radical cystectomy or concurrent chemoradiation to treat urothelial cancer demonstrated statistically similar median overall survival rates. Further analysis suggests that the hazard ratios between the two treatments change over time and is hypothesis generating.

As the fields of renal cell carcinoma and bladder cancer continue to dramatically progress with the approval of novel agents—both immune-based and targeted therapies—oncologists need to improve their methods of selecting patients to receive such available therapies.

Toni K. Choueiri, MD, clinical director, Lank Center for Genitourinary Oncology, director, Kidney Cancer Center, senior physician, Dana-Farber Cancer Institute, discusses the results of the phase II CABOSUN trial, which compared cabozantinib (Cabometyx) with sunitinib (Sutent) in the frontline setting of patients with metastatic renal cell carcinoma (RCC).

Cabozantinib (Cabometyx) reduced the risk of progression or death by 31% compared with sunitinib (Sutent) in the frontline setting for patients with metastatic renal cell carcinoma.

Early results from a pre-planned interim analysis in the KEYNOTE-052 phase II trial of first-line pembrolizumab in cisplatin-ineligible patients with metastatic urothelial cancer demonstrated antitumor activity and a favorable response rate.

Adjuvant sunitinib prolonged disease-free survival by 1.2 years compared with placebo following nephrectomy for patients with high-risk clear cell renal cell carcinoma.

Safety, efficacy, and biomarker results from the phase II CheckMate-275 trial of the PD-1 inhibitor nivolumab (Opdivo) that support FDA and European Medicines Agency applications were reported at the 2016 ESMO Congress.

In kidney cancer there are three “eras” in the history of treatment advances, said James Hsieh, MD, PhD, medical oncologist, Memorial Sloan Kettering Cancer Center.

Randy F. Sweis, MD, clinical instructor, University of Chicago Medicine, discusses the trend toward immunotherapy in the field of genitourinary malignancies.

Historically, patients with advanced renal cell carcinoma have had few treatment options, but several targeted agents and one immunotherapy, the checkpoint inhibitor nivolumab, have been approved within the past 5 years, considerably expanding the RCC treatment arsenal. In the frontline setting, targeted agents are often the go-to therapy.

Elizabeth Plimack, MD, discusses some of the most impressive advancements with immunotherapy agents in the fields of renal cell carcinoma and bladder cancer, as well as remaining questions with the use of these treatments.