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ASCO 2026 | Frontline GemFLP in advanced urachal and non-urachal urinary tract adenocarcinoma

Emanuele Crupi, MD, The University of Texas MD Anderson Cancer Center, Houston, TX, discusses findings from a Phase II study (NCT00082706) evaluating frontline gemcitabine, 5-fluorouracil/leucovorin, and cisplatin (GemFLP) in advanced urachal and non-urachal adenocarcinoma of the urinary tract. The regimen achieved a meaningful overall response rate with durable responses and favorable overall survival, with no difference in outcomes between subtypes. Elevated baseline CA125 was associated with inferior overall survival, and the toxicity profile was considered manageable. This interview took place during the 2026 American Society of Clinical Oncology (ASCO) Meeting in Chicago, IL.

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Transcript

It’s my pleasure to present this first result and mature follow-up of more than 20 years of our phase two single center, single arm, a trial on urachal and non-urachal adenocarcinoma. We enrolled 46 patients, 18 urachal and 28 non-urachal. And what we have done so far is evaluating GEMFLIP as frontline therapy for locally advanced and resectable and metastatic patients...

It’s my pleasure to present this first result and mature follow-up of more than 20 years of our phase two single center, single arm, a trial on urachal and non-urachal adenocarcinoma. We enrolled 46 patients, 18 urachal and 28 non-urachal. And what we have done so far is evaluating GEMFLIP as frontline therapy for locally advanced and resectable and metastatic patients. And what we find is with the primary outcome overall survival and objective response rate and secondary outcome have been PFS and safety, we found that we had an objective response rate of 44% in this rare disease that represents less than 1% of the patients. And we had a median progression-free survival of 4.6 months and a duration of response among the patients that responded with CR and PR of 8.6 months, with a median overall survival of 21.4 months. So it represents the first benchmark in a field where we don’t have, again, frontline therapy in this setting. It’s been manageable, safety, nothing unexpected of what we expected to have with this regimen. And what we also have found is, on the biomarker side, the CA-125 expression with HR for doubling has been associated with worse outcome.

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