This slide show includes some of the highlights from the 2014 ASCO Genitourinary Symposium, including a study looking at anti-HER2 agents and radiation therapy (RT) for bladder cancer, RT for prostate cancer, and novel therapies in RCC.
Slide 1: HER2-Targeted Therapy in Combination With Radiotherapy Is Encouraging in Bladder Cancer TrialWhile radical cystectomy is a common local treatment, older patients with comorbidities cannot undergo invasive surgery. The RTOG 0524 trial treated 21 patients (median age of 73) with paclitaxel, radiation, and trastuzumab (group 1) and 47 patients (median age of 80) with paclitaxel and radiation therapy alone (group 2). As many as 50% of patients with urothelial carcinoma have tumors that overexpress HER2. At 12 weeks, 62% (9 of 13 patients) in group 1 had a complete response while 58% (19 of 33 patients) in group 2 had a complete response. Acute toxicity was observed in 33% in group 1 and 30% of patients in group 2. Slide 2: Value of Local Radiotherapy Confirmed for Men With Locally Advanced Prostate CancerThe addition of a course of local radiotherapy to hormonal therapy for men with locally advanced or high-risk prostate cancer lowered the 10- and 15-year prostate cancer-specific mortality as compared to treatment with hormonal therapy alone, according to updated results from the Scandinavian Prostate Cancer Group VII study. After an 11-year follow-up, the 10-year cumulative prostate cancerâspecific mortality was 8.3% in patients assigned combination treatment compared with 18.9% in the anti-androgen alone arm; at 15 years, it was 12.4% compared with 30.7% in the anti-androgen alone arm.Slide 3: Prostate Cancer Patients With Favorable Prognosis May Benefit Slightly From Ipilimumab Plus RadiotherapyAlthough the phase III CA184-043 trial of ipilimumab plus radiotherapy in castration-resistant prostate cancer patients previously treated with docetaxel did not reach its overall survival endpoint, a subpopulation analysis of the 799 patients in the trial suggests that ipilimumab may be more active in patients with favorable prognostic factors (no visceral disease, alkaline phosphatase References:
1. Michaelson MD, Hu C, Pham HT, et al. The initial report of RTOG 0524: Phase I/II trial of a combination of paclitaxel and trastuzumab with daily irradiation or paclitaxel alone with daily irradiation following transurethral surgery for noncystectomy candidates with muscle-invasive bladder cancer. ASCO Genitourinary Cancers Symposium; 2014. Abstr LBA287.
2. Fossa SD, Widmark A, Klepp OH, et al. Ten- and 15-year prostate cancer-specific survival in patients with nonmetastatic high-risk prostate cancer randomized to lifelong hormone treatment alone or combined with radiotherapy (SPCG VII). ASCO Genitourinary Cancers Symposium; 2014. Abstr 4.
3. Drake CG, Kwon ED, Fizazi K, et al. Results of subset analyses on overall survival (OS) from study CA184-043: Ipilimumab (Ipi) versus placebo (Pbo) in post-docetaxel metastatic castration-resistant prostate cancer (mCRPC). ASCO Genitourinary Cancers Symposium; 2014. Abstr 2.
4. Stensland KD, McBride R, Wisnivesky JP, et al. Premature termination of genitourinary cancer clinical trials. ASCO Genitourinary Cancers Symposium; 2014. Abstr 288.
5. McKay RR, Rodriguez GE, Lin X, et al. Impact of angiotensin system inhibitors (ASI) on outcomes in patients (pts) with metastatic renal cell carcinoma (mRCC): Results from a pooled clinical trials database. ASCO Genitourinary Cancers Symposium; 2014. Abstr 437.
Slide 1: HER2-Targeted Therapy in Combination With Radiotherapy Is Encouraging in Bladder Cancer Trial. Image Source: M. Dror Michaelson, MD, PhD, Massachusetts General Hospital Cancer Center, Boston.
Slide 2: Value of Local Radiotherapy Confirmed for Men With Locally Advanced Prostate Cancer. Image Source: Sophie Dorothea Fossa, MD, Professor, Department of Oncology, Oslo University Hospital, Norway.
Slide 3: Prostate Cancer Patients With Favorable Prognosis May Benefit Slightly From Ipilimumab Plus Radiotherapy. Image Source: Charles Drake, MD, PhD, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins, Baltimore, Maryland.
Slide 4: Significant Failure Rate of Clinical Trials Shows Barrier to Progress for Certain Cancers. Image Source: Matthew D. Galsky, MD, Icahn School of Medicine at Mount Sinai.