GU Cancers 2022 | RCC & penile cancer at ASCO GU: KN-564, NeoAvAx & PERICLES

Yeah, it’s a really great session. It’s not just RCC, it’s also some other rare GU tumors. There’s an abstract on penile cancer and adrenocortical carcinoma as well. As far as the renal cell abstracts, I think one of the themes is obviously neoadjuvant versus adjuvant and how we’re using systemic therapy and the perioperative treatment of renal cell carcinoma. And so one of the abstracts presents the longer term data on KEYNOTE, which is an adjuvant study with pembrolizumab and they essentially show a durable, improved, recurrence-free survival in patients who receive pembrolizumab who are high risk after an nephrectomy. To partner with that is the trial where they looked at avelumab and axitinib in a neoadjuvant setting, and they saw about a 30% partial primary tumor response rate. And they were able to show improved disease-free survival in that cohort as well.

I think of perioperative systemic therapy for high-risk renal cell carcinoma is clearly something that we’re going to be using more of and what remains to be seen as really the optimal way to deploy that. Is it in the neoadjuvant setting? Is it adjuvant? What sort of biomarkers can we utilize to help predict what the patients will respond to? What I thought was reassuring in the neoadjuvant trial was to see that there were not increased surgical complications. That is one of the things that anecdotally a lot of us that do these types of cases have sometimes observed with immunotherapy and operating afterwards. And so I think that’s an area that needs to be explored more, but at least in this data set, when used in a neoadjuvant fashion, it seemed to be safe. Finally, there was the PERICLES trial, which was a really interesting trial for penile cancer.

This was looking at giving atezolizumab immunotherapy with or without radiotherapy for patients with locally or regional metastatic penile cancer. And penile cancer is such a tough cancer for us to collect a lot of data on because of the rarity of the disease and because of its squamous cell histology, there’s definitely been a lot of interest in whether or not PD-L1 inhibitors or PD-1 inhibitors will be effective as this works in other types of cancers that share a similar histology. And so I think that there they were able to show a good response for a set of patients who really have a dismal prognosis. And I think that more data that can help point us in the correct direction on how to best harness using the combination of these therapies is going to be really important. But it’s really promising because to date there really hasn’t been a lot to offer these patients.