Novel Therapies for Patients with Genetourinary Malignancies

By: Rana R. McKay, MD – Medical Oncologist University of California San Diego

During my presentation, I was discussing novel therapies for patients with genetic urinary malignancies. We went through a series of targeted therapies, immunotherapies, radio ligand therapies for patients with.

State kidney and bladder cancer. To give a highlight, we talked about Belzutifan and renal cell carcinoma. Belzutifan is a HIF two alpha inhibitor that has shown great promise and is looking to see additional data in the future in urothelial cancer. We talked about the combination of pembrolizumab plus Enfortumab vedotin in the frontline setting for patients with cisplatin.

Watch the Full Presentation with Slides Here: https://oncologytube.com/video/41925/what-is-belzutifan-2023-slides-kidney-cancer-breakthroughs-rana-mckay-md

And for prostate cancer, we talked about novel ways to target the androgen receptor with androgen receptor degraders including ARB 110 .

Some of the data that’s quite exciting is looking at the role of Belzutifan and renal cell carcinoma. Belzutifan is a HIF two alpha inhibitor that has shown promise in renal cell carcinoma. There were results from a Phase one study, including 55 patients who received these agents. These patients were very heavily pretreated with lots of prior drugs response rates of around 25% in that population.

And now there’s a large phase three currently ongoing of this agent compared to everolimus for patients with treatment refractory renal cell carcinoma. So certainly be on the lookout for beta fan and renal cell carcinoma.

The questions that I received after the talk were really about how to treat metastatic hormone-sensitive prostate cancer, whether we should be escalating therapy with hormones, an androgen receptor pathway inhibitor, and also chemo. And what is the role of. Chemotherapy. You know, I think it’s still evolving because the way the trials were previously conducted, trials being piece one and Acesse, they looked at , a control arm of ADT plus docetaxel as opposed to a more modern day control arm of AD t plus abiraterone or enzalutamide or Apalutamide, one of these newer hormonal agents.

So there’s a lot of questions in the field. In which patient do you need to escalate and where is it most beneficial? data that were presented from the Aen study demonstrated that the benefit of added docetaxel was seen for both low and high vole disease .The other question that I received was, what is the role of.

PARP inhibition for unselected patients with metastatic prostate cancer. We have several studies that have been reported that show somewhat conflicting results about what is the role of the utility of PARP inhibitors in this setting. I think the jury is still out about what to do.

So a lot of novel drugs that are on the horizon in genitive urinary malignaNCIes. I think the antibody drug conjugates are really interesting .These are drugs that target a specific protein in the tor, but then deliver a payload. With either chemotherapy that’s distributed directly to the cancer cell.

Additionally, radioligand therapy is also something to be on the lookout for. We now have Radioligand therapies approved for prostate cancer and they’re being investigated in kidney cancer with an agent called Girentuximab .So I think lots to come in the future.

In addition to studies that are testing different drugs, there are studies that are testing radiation modalities in renal cell carcinoma. I wanna highlight the SAMURAI trial. This is a phase two study looking at the role of radiation therapy to the primary tor for those patients receiving immunotherapy combination treatment.

This is a really important study that is asking the question of what is the role of radiation? For patients with advanced disease, that’s treating the primary tor matter .and studies enrolling through the cooperative groups through the NCI. Thank you.