Medicine Matters oncology

Dear colleagues and friends, I report to you from GU ASCO latest news from San Francisco 2020 on GU malignancies. 

We have had a lot of interesting insights in, for example, prostate cancer, where we had a post hoc analysis from the TITAN trial showing that regardless of the treatment-- whether chemotherapy or hormonal therapy in the situation mSHPC-- apalutamide statistically significant prolonged overall survival and radiographic progression-free survival. To remember, apalutamide was recently approved in Europe and several countries for the treatment of metastatic prostate cancer in the all-comer situation.

In the field of bladder cancer, I personally really liked the NIMBUS trial results presented by Professor Marc-Oliver Grimm from Jena, Germany. He tried to investigate if a reduced induction dose of BCG in high-risk superficial bladder cancer is not inferior to the standard dose. And the trial clearly showed that the standard dose is superior.

So we should stick with the standard dosing. We should not reduce BCG in case of high-risk or carcinoma in situ non-muscle invasive bladder cancer. So I think important piece of evidence of this randomized prospective phase 3 trial.

With respect to kidney cancer, there were no groundbreaking pivotal trials for approval of novel substances. However, two presentations in the plenary seminar really caught my focus. One was the Nobel Prize-awarded mechanism of HIF-2 alpha inhibition, where Toni Choueiri showed his result of his phase 2 trial with 55 patients showing in the second, third, and fourth line settings were really heavily pre-treated RCC patients, and disease control rate of 80%, 69% tumor reduction.

And what I found very remarkable, which also underscores the good tolerability of this new compound, is that after one year, 16 patients were still on treatment. So promising basis for this right now started or initiated phase 3 trial out of this.

Another interesting approach was the combination of nivolumab plus sitravatinib. Sitravatinib is a TKI-- novel TKI. And this combination in the same indication, 40 patients at least second line resulted in a 92% tumor reduction and an overall response rate of 39% and a PFS of 10.5 months. So some promising data for the next phase 3 trials in RCC here from ASCO GU.

Thanks a lot for your attention, and all the best.