With cancer being such a difficult disease to understand, treat, and—of course—cure, any knowledge that advances practice is invaluable. It naturally follows that sharing that knowledge is essential, so that researchers and clinicians can gain from the power of collaboration. This starts by providing physicians with a platform to share their knowledge with other medical professionals, which we do in this issue of Urologists in Cancer Care® with our lead story on advanced urothelial carcinoma (UC), “Checkpoint Inhibitors Herald a New Era for Treating UC.”
Matthew D. Galsky, MD, a professor of medicine in the Division of Hematology and Medical Oncology at the Icahn School of Medicine at Mount Sinai, New York, and the director of Genitourinary Medical Oncology at the Tisch Cancer Institute at Mount Sinai, shares his professional expertise on the subject. Checkpoint inhibitors are increasingly common and useful in clinical practice, and more research is focused on their use in combination with other therapies.
“Central to the immune system is a set of inhibitory pathways regulated by proteins commonly referred to as immune checkpoints, among which are cytotoxic T-lymphocyte-associated protein 4 (CTLA-4), programmed death 1 (PD-1), and the programmed death ligand 1 (PD-L1) are the most well characterized,” Galsky says in the article.
There are currently 5 agents that are major players in the PD-1 and PD-L1 space: pembrolizumab (Keytruda), nivolumab (Opdivo), durvalumab (Imfinzi), atezolizumab (Tecentriq), and avelumab (Bavencio). Galsky explains these agents, the studies that led to their approvals, and how they are helpful in treating have been very few completed clinical trials exploring CLTA-4 blockade in UC, despite preclinical evidence that this class of drugs could be effective, according to Galsky. More research is needed in this area, lest we overlook a potentially successful treatment.
With regard to our own efforts to foster collaboration, OncLive® recently hosted 2 State of the Science SummitsTM on genitourinary cancers: 1 at Duke Cancer Institute, and 1 at the University of California San Francisco (UCSF) Helen Diller Family Comprehensive Cancer Center.
One example is “PSMA-PET Agents Poised to Become Major Step Forward in Prostate Cancer Imaging,” in which Thomas Hope, MD, an assistant professor of abdominal imaging and nuclear medicine at UCSF, said that use of imaging agents with prostate-specific membrane antigen-PET can help clinicians locate the very small, subcentimeter sites of disease typical of prostate cancer in cases where disease previously would have been undetectable.
Daniel J. George, MD, a medical oncologist at Duke Cancer Center, explained that although hormonal- based therapies are a standard component of the treatment landscape of metastatic castration- resistant prostate cancer, other agents are available for first-line use that have the potential to improve outcomes in “Expert Discusses Optimizing Sequence of Non-hormonal Therapy in mCRPC.”
We should all continue to collaborate, sharing expertise and research, to help find better treatments for genitourinary cancers.