GU Cancers 2019 | Dr Toni Choueiri’s highlights from GU Cancers Symposium 2019

Great GU ASCO 2019 meeting! A lot of advancement in prostate, bladder and kidney cancer. Focusing on kidney cancer, many, many presentation; a new presentation seen for the first time that are quite interesting. In terms of combination in advanced metastatic untreated renal cell carcinoma, a combination that I presented, was axitinib, the VEGF TKI and avelumab the PD-L1 inhibitor. This was presented initially at ESMO 2018 by Dr. Moser, but we did present several sub-group analysis both in risky group, the IMDC and the MSKCC.

We looked at other sub-group, the BMI, the smoking status, we looked at response rate, not just progression-free survival. We looked at progression-free survival and response rate by independent or investigative review. The benefit was the combination of axitinib was the same and was kind of persistent. Then we looked at several other parameters, like progression-free survival 2, PFS 2, which is kind of an interesting endpoint that captures second-line treatment too; and we looked at the mean duration of response over time that can capture not just the response, but how fast the response occurred and the combination was the winner. At he same time Dr. Powles presented similar combination of axitinib, same oral drug in the axi/avelumab study but also was pembrolizumab, which is a PD-1 inhibitor. And that study met the response rate, the progression-free survival and also the overall survival at the first interim analysis.

So again, a proof of concept combining PD-1, PD-L1 inhibitor with axitinib, potent VEGF TKI makes sense here. Then several other things presented, there is a new tyrosine kinase inhibitor; many people familiar with, from a trial that didn’t lead to the approval, tivozanib. Now there is a trial that met its primary end point called TIVO-3, where tivozanib was compared to sorafenib resulted in a progression-free survival benefit. Overall, a combination also of atezolizumab and bevacizumab in non-clear cell have a response rate over 30%.

There were several abstracts dealing with metastatic non-clear cell which is an unmet need. So the atezolizumab and bevacizumab, which is a tolerated combination, more than 30% response rate, but also a trial with durvalumab and savolitinib, the MET inhibitor from, again, Dr. Powles’s showing also activity. And finally Dr. presented single-agent activity of pembrolizumab, the PD-1 inhibitor, showing around 25% actually response rate and response is seen in most histology but at a variable degree. Again, very exiting meeting, again in new information and I can’t wait for the next meeting; probably ASCO 2019. Thank you very much.