GU Cancers 2022 | Highlights from ASCO GU 2022

There’s certainly a few bladder studies that are being presented, that are quite interesting and intriguing. I started talking about a new HER2-targeting agent. This is trastuzumab deruxtecan, which is given in combination with nivolumab an anti-PD-1 antibody, showed some encouraging preliminary efficacy results, although in a fairly small study, but more than 30%, I believe it was 34/36% of patients with high HER2 expression had an objective response to this combination therapy. And these were patients that were mostly previously pretreated with other therapies. Other trials I’m excited about at this conference include presentation of the initial neoadjuvant data for enfortumab vedotin as part of cohort H of the EV-103 study. This was just to review the EV-103 trial is a multi cohort study of enfortumab vedotin, monotherapy and also in combination with other agents.

This cohort H investigated enfortumab vedotin with up to three cycles in patients with muscle invasive urothelial cancer, who were intended to undergo radical cystectomy and among the 20 or so patients evaluated in this study, the pathologic complete response rates at the time of radical cystectomy were in 30 to 40% range. Again, it was 36% and this is comparable to what we expect to see with platinum-based or specifically cisplatin-based chemotherapy in this space. And for a drug that’s better tolerated that cisplatin-based chemotherapy. So these results are certainly encouraging and inform the development of future trials of enfortumab vedotin in the perioperative space. And there are a few larger Phase III studies that are coming. I would also say that presentation of the TROPHY study cohort 3 was interesting. This is also a multi cohort study, but of combinations of sacituzumab govitecan, the other main antibody drug conjugate used for urothelial cancer, this cohort investigated the use of sacituzumab govitecan and in combination with pembrolizumab in patients refractory to platinum based chemotherapy.

An objective response rate, I should say of 34% was observed in an initial subset of patients of about 20 patients, which again is encouraging for the further development of this combination. Finally, I should mention something from the prostate day, which was earlier, and particularly interesting and potentially practice changing study was the ARASENS study, in which patients with metastatic hormone-sensitive prostate cancer were randomized to receive either combination of lupron or androgen deprivation therapy (ADT), basically, with docetaxel chemotherapy and darolutamide versus androgen deprivation therapy with docetaxel and placebo. And the triplet therapy arm, the ADT with docetaxel with darolutamide was shown to improve overall survival in patients treated with the triplet therapy, as opposed to patients treated with ADT and docetaxel alone. These results are very encouraging and potentially practice changing for a subset of patients with prostate cancer. And so I think was really the highlight of the studies presented during the prostate portion of this conference.