Genitourinary Cancer—Prostate, Testicular, and Penile

Oncoletter provides you with quotes from the abstract's conclusions. To see more, go the ASCO Meeting Library while clicking on the link of the study-titles (to see videos and slides needs a payable registration)
 
The abstract concludes: 
In men with docetaxel-treated mCRPC, LuPSMA was more active (PSA50-RR) than cabazitaxel with relatively fewer G3-4 AEs and PSA-PFS favoring LuPSMA. Clinical trial information: NCT03392428.
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Michael J. Morris, Peter R. Carroll, Lawrence Saperstein, et al.
 
The abstract concludes: 
PSMA-targeted PyL-PET/CT detected and localized occult disease in most men with BCR presenting with negative or equivocal conventional imaging. PyL-PET/CT led to changed management plans in the majority of pts, thus providing evidence that clinicians find PSMA PET imaging useful in men with recurrent or suspected metastatic PCa. Clinical trial information: NCT03739684.
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Thomas A Hope, Wesley R Armstrong, Vishnu Murthy, et al.
 
The abstract concludes: 
In intermediate to high risk PCa patients who underwent RP and PLND, 68Ga-PSMA-11 PET detected pelvic nodal metastases with a sensitivity of 0.40 and a specificity of 0.95. Higher PSAs and larger node size correlated with increased sensitivity. Clinical trial information: NCT03368547, NCT02611882, NCT02919111.
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Rana R. McKay, Wanling Xie, Fiona M. Fennessy, et al.
 
The abstract concludes: 
Intense neoadjuvant hormone therapy followed by RP in men with high-risk PC resulted in favorable pathologic responses (<5 mm residual tumor) in 21% of patients. Pathologic responses were similar between the treatment arms. Follow-up is necessary to evaluate the significance of a pathologic response on recurrence rates. Part 2 of this trial will investigate the impact of an additional 12 months of APAL post-RP on biochemical recurrence. A phase 3 trial investigating neoadjuvant apalutamide + leuprolide prior to RP is ongoing. Clinical trial information: NCT02903368.
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Ramaprasad Srinivasan, Sandeep Gurram, Munjid Al Harthy, et al. 
 
The abstract concludes: 
The combination of bevacizumab and erlotinib is well tolerated and is associated with encouraging activity in advanced pRCC, particularly in patients with FH deficient tumors. This is the first and largest prospective study in HLRCC and provides the basis for considering bevacizumab and erlotinib as a preferred option in a patient population that has no widely accepted standard. Clinical trial information: NCT01130519.
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Fernando C. Maluf, Andre P. Fay, Vinícius Carrera Souza, et al.
 
The abstract concludes: 
The AAP+ADT and APA+AAP groups showed high effectiveness in terms of PSA response. Radiologic disease control and the decline of ≥ 80% in PSA at week 25 were similar among all treatment arms. APA alone had less toxicity. APA+AAP and APA alone are promising regimens in this setting. No new safety signal was detected in the study. Clinical trial information: NCT02867020.
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Michael B. Atkins, Opeyemi Jegede, Naomi B. Haas, et al.
 
The abstract concludes: 
Nivo monotherapy is active in treatment naïve ccRCC across all IMDC groups. Toxicity is consistent with prior nivo studies. Salvage treatment with nivo/ipi after nivo monotherapy was feasible in 53% of pts with PD/pSD, with 11% responding. Clinical trial information: NCT03117309.
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Eric Jay Small, Shuang Zhao, William S. Chen, et al.
 
The abstract concludes: 
This integrated study of whole-genome, whole methylome and whole-transcriptome sequencing provides the first comprehensive overview of the important regulatory role of methylation in metastatic castration-resistant prostate cancer, and has identified at least two distinct subtypes. The clinical and therapeutic implications of methylation subtypes should be explored in future studies. Clinical trial information: NCT02432001.
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Jane Goodall, Zoe June Assaf, Zhen Shi, et al.
 
The abstract concludes: 
ctDNA analyses may help (i) identify poorer prognosis disease at baseline, (ii) inform on treatment response (CR/PR/SD/PD) and radiological progression free survival (rPFS) in on-treatment (C3D1) samples, and (iii) can elucidate emerging resistance mechanisms at disease progression. Clinical trial information: NCT01485861.
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5515 Final overall survival (OS) from PROSPER: A phase III, randomized, double-blind, placebo (PBO)-controlled study of enzalutamide (ENZA) in men with nonmetastatic castration-resistant prostate cancer (nmCRPC).

Cora N. Sternberg, Karim Fizazi, Fred Saad, et al.

The abstract concludes: 

ENZA treatment resulted in a statistically significant 27% reduced risk of death compared with PBO, demonstrating that initiation of ENZA + ADT before the onset of detectable metastasis improves OS in men with CRPC and rapidly rising PSA. This OS benefit ensues despite crossover from the PBO arm to ENZA and higher rates of subsequent antineoplastic therapies in men from the PBO arm. Safety was consistent with previous clinical trials. This final OS analysis from PROSPER provides prospective validation of MFS as a potential surrogate endpoint for OS in nmCRPC and supports the continued use of ENZA + ADT as a standard of care in men with nmCRPC and rapidly rising PSA. Clinical trial information: NCT02003924.

Published simultaneously on NEJM:

Trastuzumab Deruxtecan in Previously Treated HER2-Positive Gastric Cancer

K. Shitara and Others

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5602 HERO phase III trial: Results comparing relugolix, an oral GnRH receptor antagonist, versus leuprolide acetate for advanced prostate cancer.

Neal D. Shore, Daniel J. George, Fred Saad,et al.

The abstract concludes: 

Relugolix achieved castration as early as Day 4 and demonstrated superiority over leuprolide in sustained T suppression through 48 weeks, faster T recovery after discontinuation and a 50% reduction in MACE. Relugolix has the potential to become a new standard for T suppression for patients with advanced prostate cancer. Clinical trial information: NCT03085095.

Published simultaneously on NEJM:

Oral Relugolix for Androgen-Deprivation Therapy in Advanced Prostate Cancer

N.D. Shore and Others

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Highlighted Poster:
 
5538 Impact of olaparib vs physician’s choice of new hormonal agent (pcNHA) on burden of pain in metastatic castration-resistant prostate cancer (mCRPC): PROfound.

Fred Saad, Guilhem Roubaud, Giuseppe Procopio, et al.

The abstract concludes: 

Olaparib reduced the burden of pain and time to first opiate use in pts with mCRPC and HRR gene alterations vs pcNHA, demonstrating a clinical and symptomatic patient benefit. Clinical trial information: NCT02987543.

Simultaneously published in the NEJM:

Olaparib for Metastatic Castration-Resistant Prostate Cancer

Johann de Bono, Joaquin Mateo, Karim Fizazi, et al.

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Genitourinary (Abstracts #5500, 5501, 5503)
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