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Medicine Matters oncology

Dear colleagues, dear friends, just a short wrap up from my sight for Medicine Matters Oncology, ASCO 2021. I will focus on the three big GU tumors-- renal cancer, prostate cancer, and bladder cancer-- and give my personal insights, what I thought was somehow game changing and very interesting in those three malignancies.



So let's start with renal. I think-- and we've had Tony Choueiri here on the network, and great to have Tony here speaking on the late breaking abstract on the presentation on the KEYNOTE-564 trial. He well demonstrated the trial showing that there was a statistically significant and I think also clinically meaningful reduction in the risk of disease recurrence or death by 32% compared to placebo-- highly statistically significant.



The two year estimated disease free survival rate was 77.3%, with pembrolizumab compared to 68.1% with placebo. So personally, I think we need to await overall survival benefits here the results in the future. We also need to discuss which patient group is best eligible for pembrolizumab, since we saw some 20% of treatment related stop of the treatment. And so, we surely know that even IO treatment is well tolerated. It has some IO specific side effects.



So we definitely have to discuss interdisciplinary on which patients are best for adjuvant pembro treatment post nephrectomy or renal surgery. So I think, very great presentation by Dr Tony Choueiri on the KEYNOTE-564 trial.



Some more interesting data on renal cancer was the CANTATA trial, which I personally was looking forward to the combination of cabo with telaglenastat and cabozantinib alone in pre-treated advanced renal cell carcinoma patients presented by Nisar Tannir. Unfortunately, the combination showed no benefit. So this is probably not the mode of action we will continue to investigate in the future.



I think from CheckMate 920, Nivo/Ipi in patients with brain metastasis, I was surprised to see 63% alive at two years. So I think combination Ipi/Nivo really is a good choice in patients with brain mets.



Switching over to the topic of prostate cancer. Here, surely we had the VISION trial result presented by Michael Morris, already covered here in Medicine Matters Oncology. So I think the VISION trial showing the activity of 177 lutetium PSMA targeted therapy as third line treatment after failure of novel hormone treatment and some taxane treatment. So here, we have another option for treating men with third line or second line failure in advanced metastatic CRPC.



Very interesting data. Surely, we have other options like cabazitaxel, and personally, head to head comparison in this situation showed benefit of lutetium therapy. Nowadays, we also have precision medicine for the men with BRCA1 or 2 alterations. We have olaparib approved and rucaparib in the US. So it goes to precision medicine in advanced prostate cancer.



In metastatic and advanced bladder cancer, the enfortumab vedotin substance is still under very much interest also at this year's ASCO. We have seen the updated EV-1 or 3 results, showing a very promising combination of EV and pembrolizumab, with an overall response rate of 57.8% complete remission in 15.6% in first line setting of metastatic urotelial carcinoma. So this is definitely a promising combination in first line treatment. Phase three trial is running.



Then, the updated analysis of the EV-201 cohort two. Those are the patients with which were cisplatin ineligible post IO. Here, enfortumab vedotin showed a 51% overall ORR reduction, and 22% complete remission. Very promising results, reassuring the benefit of EV in this patient population.



At the end, in the EV story, the 301 results, quality of life were presented, showing that the quality of life is conserved and treatment-- as we've seen at ASCO GU is very efficient in this situation in metastatic and pre-treated patients with advanced urothelial carcinoma.



So I think this is just a short summary of some highlights-- my personal highlights. Surely, there were much more very interesting other results I wasn't able to cover now, due to time limitations. But we promise to update you with some more results on Medicine Matters Oncology. So thanks a lot. Thanks for trust. Stay safe, stay healthy, all the best. And see you at ESMO 2021.