Genitourinary Cancers

It was once thought that after guiding the development of male sex organs in a fetus, the Y chromosome did not do much else. But over the past few years, results from multiple studies have challenged that belief.
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Surgery is typically the gold standard for patients with biopsy-proven, clear cell, renal cell carcinoma with no evidence of metastatic disease, said Eric Jonasch, MD, in a session during the 2023 National Comprehensive Cancer Network Conference. In this setting, there is probably not a role for systemic neoadjuvant treatment, as response rates of 15% to 45% have been recorded with axitinib (Inlyta), sunitinib (Sutent), and other tyrosine kinase inhibitors.
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An analysis from the ARASENS trial showed that the addition of darolutamide to androgen-deprivation therapy and docetaxel significantly improved overall survival in subgroups of patients with metastatic hormone-sensitive prostate cancer with high-volume and high-risk disease and should be considered the new standard of care for this patient population.
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During the 2023 American Society of Clinical Oncology Genitourinary Cancers Symposium, a panel of experts identified some of the key challenges to achieving health equity in bladder cancer care and discussed what can be done to improve access to clinical trials, mitigate financial toxicity, and promote value-based care.
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The decision to use adjuvant therapies in patients with renal-cell carcinoma (RCC) should be based on risk, patient goals, and shared decision-making. This topic was explored in a presentation by Matthew Zibelman, MD, Associate Professor, Hematology/Oncology, Fox Chase Cancer Center, Philadelphia, PA, at the 2023 American Society of Clinical Oncology Genitourinary Cancers Symposium.
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On December 22, 2022, the FDA accelerated the approval of mosunetuzumab-axgb (Lunsumio; Genentech), a bispecific CD20-directed CD3 T-cell engager, for adults with relapsed or refractory follicular lymphoma after ≥2 lines of systemic therapy. The FDA granted this indication breakthrough therapy and orphan drug designations.
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Combining the PARP inhibitor olaparib (Lynparza) with abir­aterone acetate (Zytiga) led to a statistically significant and clinically meaningful improvement in radiographic progression-free survival (PFS) versus abiraterone alone in patients with metastatic castration-resistant prostate cancer (mCRPC), regardless of homologous recombination repair (HRR) status, according to results of the phase 3 PROpel trial.
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The addition of sacituzumab govitecan (Trodelvy), an antibody–drug conjugate, to the PD-1 inhibitor pembrolizumab (Keytruda) showed encouraging antitumor activity in checkpoint inhibitor–naïve patients with metastatic urothelial cancer, according to an analysis of the results of cohort 3 from the phase 2 TROPHY-U-01 clinical trial.
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San Francisco, CA—De-escalating chemotherapy based on a negative positron- emission tomography (PET) scan after 2 cycles of treatment is safe and feasible in most patients with low-volume metastatic seminoma, the most common type of testicular cancer, according to results presented at the 2020 Genitourinary Cancers Symposium.
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San Francisco, CA—Delivering the keynote address at the 2020 Genitourinary Cancers Symposium, David F. Penson, MD, MPH, MMHC, Hamilton and Howd Chair in Urologic Oncology, Vanderbilt University Medical Center, Nashville, TN, highlighted the need to move toward patient-centered decisions beyond survival, focusing on patient-centered outcomes by integrating quality of life (QOL) and financial toxicity into the shared, treatment-related, decision- making process.

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