Bladder cancer research highlights from ASCO GU 2024
ASCO Genitourinary Cancer Symposium is the leading annual meeting organised by the American Society of Clinical Oncology on January 25-27, 2024. It focuses on genitourinary cancers and scientific research in this field. We have selected four bladder cancer research studies presented at ASCO GU, with lay summaries of each study provided below.
This year, World Bladder Cancer Patient Coalition (WBCPC) also marked a significant achievement by presenting the Global Bladder Cancer Patient & Carer Survey findings poster at the ASCO GU.
Research Analyzes Best Treatment Order of Erdafitinib and Enfortumab Vedotin for Bladder Cancer with Specific Genetic Changes
Bladder cancer can sometimes have changes in genes called FGFR2 and FGFR3. The study explored if giving a drug called erdafitinib (which targets these gene changes) before or after another drug called enfortumab vedotin (which targets cancer cells in a different way) could make a difference in how well patients do.
The researchers used information from a database called UNITE, which collected data from patients at 16 places in the USA who were being treated for this advanced form of bladder cancer. They looked at how long patients lived and how long it took for their cancer to worsen after starting treatment with these drugs. They wanted to see if one order of drugs worked better than the other.
They found 94 patients who had the specific genetic changes and who received both drugs, but in different orders. Some patients got erdafitinib first and then enfortumab vedotin, while others got them in the reverse order. They also looked at how well the treatments worked in terms of shrinking the cancer.
The results showed that the order of the drugs didn’t really change how long patients lived. However, both approaches were better than using enfortumab vedotin alone. This suggests that for patients with these gene changes, both drugs are highly effective, but the order in which they are received might not be crucial.
Dr Jiang concluded that what really matters is that patients with these specific gene changes in their bladder cancer get treated with both drugs during their treatment course, as this seems to offer them the best chance at fighting the disease.
This study is a step forward in understanding how to better treat this specific group of bladder cancer patients, focusing on the genetic makeup of their cancer to guide treatment decisions.
Global Study Reveals Results of Advanced Bladder Cancer Treatment with Enfortumab Vedotin and Pembrolizumab Compared to Chemotherapy
For a long time, doctors have used a combination of chemotherapy drugs to treat advanced bladder cancer. Now, there’s a new approach using two drugs: enfortumab vedotin and pembrolizumab. These drugs were tested against the usual chemotherapy in patients who hadn’t been treated yet for their advanced cancer.
The results were promising. Patients who received the new drug combination lived longer without their cancer getting worse—about 12.5 months compared to 6.3 months with standard chemotherapy. They also lived longer overall, with a median survival of 31.5 months compared to 16.1 months.
Safety was also a big part of the study. The new treatment had side effects, but they were generally manageable, and fewer patients experienced the most severe side effects compared to those receiving chemotherapy.
New Study Compares a Combination of Disitamab Vedotin and Pembrolizumab Against Standard Chemotherapy for Advanced Bladder Cancer Patients with HER2
Bladder cancer, especially when it spreads or can’t be removed with surgery, is tough to treat. A newer approach combining two drugs, disitamab vedotin and pembrolizumab, has shown potential.
Disitamab vedotin targets a protein called HER2, found in many cancer types, including half of all bladder cancers. This protein often signals a more aggressive disease. The drug works by delivering a potent cancer-killing agent directly to the cancer cells, minimising damage to healthy ones. Pembrolizumab helps the immune system recognise and fight cancer cells. Early results suggest that using these drugs together could offer a powerful new treatment option.
The DV-001 study is recruiting patients with HER2-positive advanced bladder cancer who haven’t received treatment yet. It will compare the effectiveness of this new drug combo against traditional chemotherapy. The main goals are to see if patients live longer and how the disease progresses with this treatment.
New Treatment for Advanced Bladder Cancer Shows High Response Rate
Dr Rohit Jain presented findings from a Phase Ib trial that explored a new combination therapy for patients with metastatic urothelial carcinoma, specifically those with FGFR2/3 genetic changes. These alterations are found in some patients’ cancer cells and can drive tumour growth.
The trial tested a combination of two drugs: erdafitinib, which targets the FGFR2/3 genetic alterations, and enfortumab vedotin, which attacks cancer cells through a different mechanism. The aim was to see if this dual approach could be more effective for patients who have already tried and progressed after standard treatments like platinum-based chemotherapy and PD-1/L1 inhibitors, which are common immune therapies.
The study’s results were promising, showing that the combination of erdafitinib and enfortumab vedotin was not only safe and tolerable but also highly effective in treating metastatic urothelial carcinoma. All nine patients who completed the initial phase of the trial responded to the treatment, with one achieving complete remission and the others showing significant reductions in their cancer.
This trial marks a significant step forward, suggesting that targeting specific genetic alterations in cancer cells, alongside using drugs that can directly kill these cells, might offer a new, effective treatment avenue for patients with advanced bladder cancer.
The researchers are continuing to expand this study to understand the benefits of this combination therapy. They are also considering combining these drugs with pembrolizumab, another immune therapy, to see if it could enhance treatment outcomes even further.