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GU Cancers 2019 | Antibody-drug conjugates in advanced urothelial cancer: sacituzumab govitecan

Matthew Milowsky, MD, of the UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC, discusses the results of sacituzumab govitecan in treating advanced urothelial cancer. Speaking at the 2019 Genitourinary Cancers Symposium, held in San Francisco, CA, Dr Milowsky highlights the promising responses to the drug in patients previously treated with checkpoint inhibitors or chemotherapy.

Transcript (edited for clarity)

Dr. Tagawa and colleagues presented the sacituzumab data in patients with advanced urothelial cancer, and these were predominantly a heavy pretreated patient population. Thirty-eight percent of those patients had actually received prior checkpoint inhibitors and demonstrated promising response rate of 31% as well as responses in patients who were previously treated with checkpoint inhibitors and patients with visceral metastatic disease, including liver metastases with responses in about a third of patients, which we know historically is a very difficult patient population to treat...

Dr. Tagawa and colleagues presented the sacituzumab data in patients with advanced urothelial cancer, and these were predominantly a heavy pretreated patient population. Thirty-eight percent of those patients had actually received prior checkpoint inhibitors and demonstrated promising response rate of 31% as well as responses in patients who were previously treated with checkpoint inhibitors and patients with visceral metastatic disease, including liver metastases with responses in about a third of patients, which we know historically is a very difficult patient population to treat.

There was some durability to those responses, and toxicity was present. There was gastrointestinal toxicity, most notably diarrhea, in about 70% of patients. There was also issues related to nausea, some fatigue, and then myelosupression, 38% grade 3-4 with a 7% febrile neutropenia rate. So, I think you need to be thoughtful about the type of patient that you’re treating in understanding what the toxicity profile is to know whether or not it’s best to apply that particular drug to that particular patient.

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