ASCO 2023 | Understanding variant histologies in urothelial carcinoma: IO and cabozantinib’s potential

Patrizia Giannatempo, MD, Foundation IRCCS National Cancer Institute, Milan, Italy, highlights the importance of understanding variant histologies in the context of treatment options for urothelial carcinoma, particularly immunotherapy and therapies like cabozantinib in neoadjuvant settings. Variant histologies in urothelial carcinoma often have limited alternatives compared to standard chemotherapy, and cystectomy is typically the first choice. However, emerging data from studies such as the Phase III KEYNOTE-045 (NCT02256436) and Phase II ARCADIA (NCT03824691) trials indicate that the treatment landscape for variant histologies could potentially change in the future. It is crucial to identify which subtypes of variants could benefit from pembrolizumab or the combination of durvalumab and cabozantinib. While the Arcadia trial is still ongoing and requires completion with 120 treated patients, the preliminary results are promising, indicating the need to further explore and understand the potential benefits of these treatments for variant histologies. This interview took place at the American Society of Clinical Oncology (ASCO) 2023 Annual Congress in Chicago, IL.

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