D. De Maeseneer MD

Highlights in genitourinary cancers

SUMMARY

The 2023 annual ESMO meeting again offered striking presentations about the latest trial updates in genitourinary cancers, including prostate, renal cell and urothelial cell carcinomas. This article will give an overview of the key highlights presented during this meeting in this setting.

(Belg J Med Oncol 2023;17(8):313–8)

Highlights in genitourinary cancers

SUMMARY

The 2023 annual ASCO meeting offered once more remarkable presentations about the last trial updates in renal cell, bladder, testicular and prostate cancer. This article will give an overview of the key highlights presented during this meeting in this setting.

(Belg J Med Oncol 2023;17(5):169–77)

Highlights in genitourinary cancers

The 2022 annual ESMO meeting again offered striking presentations about the last trial updates in genitourinary cancers, including prostate, renal cell and urothelial cell carcinomas. This article will give an overview of the key highlights presented during this meeting in this setting.

(Belg J Med Oncol 2022;16(8):372–9)

Practical guidance for molecular testing in metastatic prostate cancer: A Belgian perspective

SUMMARY

The recent approval of the poly(ADP-ribose) polymerase (PARP) inhibitor olaparib for the treatment of patients with metastatic castration-resistant prostate cancer (mCRPC) harbouring pathogenic variants of BRCA2 or BRCA1 marks the start of molecularly guided precision medicine in prostate cancer. In parallel with this approval comes the need to embed molecular diagnostics in the clinical management of patients with mCRPC. To date, however, there are no established protocols in Belgium for the use of mutation testing in this setting. This article will therefore provide practical guidance for sample preparation and handling, pre-analytic processing, and pathogenic variant analysis in mCRPC. Across the different phases of this process, a multidisciplinary approach involving urologists, oncologists, radiologists, pathologists, molecular biologists, technicians, nurses, and geneticists will be key to safeguard adequate sample selection to perform molecular analyses at the time of metastatic disease. It will also facilitate high-quality molecular testing with a minimal failure rate. Only by optimising this process will physicians be able to adequately select mCRPC patients that are most likely to benefit from PARP inhibition, or other future targeted therapies, allowing to use these agents in the correct patient groups.

(BELG J MED ONCOL 2022;16(7):343–54)

Highlights in genitourinary cancer

SUMMARY

The 2022 ASCO Annual Meeting again offered a variety of advancements in the treatment of genitourinary cancers. In this summary, some of the highlights in the field of renal, bladder and prostate cancer will be discussed, with a particular focus on studies with a potential impact on clinical practice.

(Belg J Med Oncol 2022;16(5):214–22)

Highlights in genitourinary cancers

ESMO 2021 again provided a variety of innovations in the management of genitourinary cancers. In prostate cancer (PCa), results of STAMPEDE suggest that early intensification of adjuvant therapy with ADT and abiraterone could become a new standard in high-risk non-metastatic PCa (currently off-label). Studies in metastatic castration-resistant PCa (mCRPC) indicated promising activity of 77Lu-PSMA-617 plus pembrolizumab and of cabozantinib plus atezolizumab. In the field of kidney cancer, patient-reported outcome data of KEYNOTE-564 further support adjuvant pembrolizumab as a new standard of care. Other studies in renal cell cancer (RCC) showed that treatment breaks during tyrosine kinase inhibitor therapy may be highly cost-effective without an effect on patient survival, that antibiotics can severely compromise survival outcomes in nivolumab-treated metastatic RCC patients and that therapeutic targeting of HIF-2α and VEGF may be effective in patients with metastatic clear cell RCC. In addition, cabozantinib proved to be safe and effective in patients with metastatic collecting ducts carcinoma. In urothelial cancer, dose-dense MVAC was identified as a safe and effective neoadjuvant treatment option for patients with muscle-invasive bladder cancer (MIBC). In metastatic urothelial cancer the addition of cetrelimab to erdafitinib seemed to increase treatment effects, while the EphrinB2-blocking agent sEphB4-HAS was found to have synergistic activity with pembrolizumab. Finally, an exploratory analysis of the pivotal IMvigor 130 trial found that cisplatin but not carboplatin seems to enhance anti-tumour immunity.

(BELG J MED ONCOL 2021;15(8):398–405)

Highlights in genitourinary cancers

The 2021 ASCO Annual Meeting offered a variety of advancements in the treatment and detection of genitourinary cancers. For prostate cancer (PCa), matched tumour-normal tissue sequencing was shown to be the ideal standard of care (SOC) in de novo high-risk PCa patients. The addition of immune checkpoint inhibitors (ICI) to the SOC was found to be highly effective in muscle-invasive bladder cancer, with enfor-tumab vedotin (EV) continuing to show efficacy in urothelial carcinoma in a post-ICI advanced/ metastatic setting. Finally, the combination of ICI and tyrosine kinase inhibitors (TKIs) as first-line therapy for both non-clear cell and clear cell renal cell carcinoma (non-cc/ccRCC) displays a clear survival benefit, with this efficacy extending into the second-line treatment of patients with metastatic non-ccRCC who have previously received ICIs. The most important headline presentations relating to genitourinary cancers will be discussed in this congress highlights article.

(BELG J MED ONCOL 2021;15(5):256-63)