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ESMO 2023 | Breakthroughs in urothelial cancer treatment at ESMO 2023

Joaquim Bellmunt, MD, PhD, Harvard Medical School, Boston, MA, highlights key findings from ESMO 2023. The Phase III EV-302 (NCT04223856) study assessed enfortumab vedotin and pembrolizumab (EV+P) versus standard chemotherapy in untreated advanced/metastatic urothelial cancer. EV+P significantly improved progression-free survival (PFS) and overall survival (OS), reducing progression and death risks by 55% and 53%, respectively, making it a new standard of care. In the Phase III CheckMate 901 (NCT03036098) trial, nivolumab (NIVO) with gemcitabine-cisplatin (GC) outperformed GC alone in first-line unresectable/metastatic urothelial carcinoma, improving OS and PFS. This marks the first concurrent checkpoint inhibitor and chemo combination enhancing OS in this setting. Dr. Bellmunt also mentions a double antibody drug conjugate (DAD) Phase I trial (NCT04724018) evaluating the combination of EV and sacituzumab govitecan (SG) in metastatic urothelial carcinoma. Despite 70% of patients experiencing grade 3 or higher adverse events, the objective response rate was 71%. Further studies, including triplet therapy with immunotherapy, are being explored for treatment-refractory urothelial carcinoma, suggesting promising directions for bladder cancer treatment. This interview took place at the European Society for Medical Oncology (ESMO) 2023 Congress in Madrid, Spain.

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