Cretostimogene Grenadenorepvec May be ‘Attractive’ Option for NMIBC

Commentary
Video

Cretostimogene grenadenorepvec’s efficacy compares favorably with the current nonsurgical standards of care in high-risk, Bacillus Calmette Guerin–unresponsive non-muscle invasive bladder cancer.

Treatment with cretostimogene grenadenorepvec yielded a high complete response (CR) rate in a population of patients diagnosed with high-risk, Bacillus Calmette Guerin (BCG)–unresponsive non-muscle invasive bladder cancer (NMIBC), according to Mark D. Tyson, II, MD, MPH.

In a conversation with CancerNetwork® during the 2023 Society of Urologic Oncology (SUO) Annual Meeting, Tyson, a urologic oncologist of the Department of Urology at Mayo Clinic in Phoenix, Arizona, discussed how cretostimogene appears to demonstrate favorable efficacy in the context of other nonsurgical standards of care in the space such as nadofaragene firadenovec-vncg (Adstiladrin) and pembrolizumab (Keytruda).

Cretostimogene grenadenorepvec was assessed as part of the phase 3 BOND-003 trial (NCT04452591) in patients with high-risk, BCG-unresponsive NMIBC, the interim results of which were read out at the meeting. In a population of 116 patients, investigators reported a CR rate of 75.7% (95% CI, 63.0%-85.0%). Of these responses, 74.4% lasted for a minimum of 6 months. Additionally, the 3-month and 6-month CR rates, respectively, were 68.2% and 63.6%.

Transcript:

This is an interim analysis that compares favorably to the 2 current nonsurgical co-standards, nadofaragene and pembrolizumab. In terms of the complete response rate, the 76% CR rate at any time point compares favorably to the 51% observed with nadofaragene, [as well as] the 41% observed with pembrolizumab. And then the 6-month CR rate of 64% compares favorably with the 41% observed for nadofaragene and the 36% observed for pembrolizumab.

Now, these are interim results; it's really hard to compare across studies. I'm not necessarily saying that cretostimogene monotherapy is better, but I am saying that it does appear to compare favorably, and I do think it will be a really attractive option for many patients looking to preserve their bladder.

Reference

Tyson M, Uchio E, Jong-Kil N, et al. First results from BOND-003, a phase 3 study of intravesical cretostimogene grenadenorepvec monotherapy for patients with high-risk BCG- unresponsive non-muscle invasive bladder cancer. Presented at: 2023 Society of Urologic Oncology Annual Meeting; November 28-December 1, 2023; Washington, DC; LBA3396.

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