AUA 2021
AUA 2021
AUA 2021: Pre-Surgical Multiparametric Magnetic Resonance Imaging Features Predicting Continence After Robotic Radical Cystectomy With Orthotopic Bladder Reconstruction: Preliminary Findings Form PURE-01 Trial
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AUA 2021: Utility of Blue Light Flexible Cystoscopy for Bladder Cancer Surveillance after Intravesical Therapy
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(UroToday.com) Most patients newly diagnosed with bladder cancer have non-muscle invasive disease (NMIBC). While the risk of disease progression is non-negligible, a significant portion of the health care burden associated with this condition is due to recurrence. Previous studies have demonstrated that the use of blue light flexible cystoscopy (BLFC) may increase the detection of additional cancers missed with white light cystoscopy (WLC) alone. However, its role in the surveillance of patients following intravesical therapy has not been established. In a podium presentation at the American Urologic Association Virtual Annual Meeting, Dr. Seyedian and colleagues presented the results of their analysis examining this question.
AUA 2021: Intravesical Therapy in Patients with Intermediate-Risk Non-Muscle-Invasive Bladder Cancer: A Systematic Review and Network Meta-Analysis of Oncologic Outcomes
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(UroToday.com) Most patients newly diagnosed with bladder cancer have non-muscle invasive disease (NMIBC). For patients with intermediate or high-risk NMIBC and those with carcinoma in situ (CIS), adjuvant treatment is guideline-recommended on the basis of proven benefits in disease recurrence. While bacillus calmette-guérin (BCG) is preferred in those with high-risk disease, both intravesical chemotherapy and BCG are options in intermediate-risk disease.
AUA 2021: Impact of the COVID Pandemic on the Diagnosis and Treatment of Urologic Cancers
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AUA 2021: Avelumab First-Line Maintenance for Advanced Urothelial Carcinoma in the JAVELIN Bladder 100 Trial: Subgroup Analysis by Duration of Treatment-Free Interval from End of Chemotherapy to Start of Maintenance
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(UroToday.com) Advanced urothelial carcinoma has among the worst prognosis for tumors treated by genitourinary oncologists. Standard of care dictates that patients receive platinum-based induction chemotherapy. However, even with this treatment, rates of recurrence and disease progression are high and overall survival is quite short due to the development of chemotherapy resistance. In the JAVELIN Bladder 100 study which was reported at ASCO 2020 Virtual Annual Meeting and subsequently published, the addition of avelumab, a PD-L1 directed therapy, as first-line maintenance to best supportive care (BSC) demonstrated improvements in overall survival for patients who did not have disease progression during their initial cytotoxic chemotherapy induction. However, the optimal timing for starting avelumab after completing 1L chemotherapy is unknown.
AUA 2021: Prospective Study of 68Ga-RM2 PET/MRI in Patients With Biochemically Recurrent Prostate Cancer and Negative Conventional Imaging
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AUA 2021: A High Through-Put Test Interrogating 442 Small Non-Coding RNAs Extracted from Urine Exosomes Accurately Identifies and Stratifies Prostate Cancer into Low-, Intermediate- or High-Risk Disease
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(UroToday.com) The American Urologic Association (AUA) annual meeting included a late-breaking abstract session with a presentation by Dr. Laurence Klotz discussing results of the Sentinel® Prostate Cancer Platform, a test for stratification of prostate cancer risk groups. The miR Sentinel® PCC4 Test measures the expressions of 442 small non-coding RNAs extracted from urinary exosomes to differentiate patients with no molecular evidence of prostate cancer from those with molecular evidence of prostate cancer. The test further classifies men with molecular evidence of prostate cancer into low-, intermediate- or high-risk disease. At the AUA meeting, Dr. Klotz and colleagues presented the results of their study comparing the miR Sentinel® PCC4 Test to systematic core needle biopsy in men presenting with initial suspicion of prostate cancer.
AUA 2021: Masitinib Plus Docetaxel as First-Line Treatment of Metastatic Castrate Refractory Prostate Cancer: Results from Study AB12003
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(UroToday.com) The American Urologic Association (AUA) annual meeting included a late-breaking abstract session with a presentation by Dr. Michel Pavic discussing results of the AB12003 trial assessing masitinib plus docetaxel as first-line treatment of metastatic castration-resistant prostate cancer (mCRPC). Masitinib is an oral, small molecule drug that targets mast cell and macrophage activity. These innate immune cells are critical components of the tumor microenvironment and are associated with prostate cancer progression. Previously, a small trial (AB07004) showed that masitinib plus docetaxel slowed progression in patients with mCRPC.
AUA 2021: MRI-guided Focused Ultrasound Focal Therapy for Intermediate-Risk Prostate Cancer: Final Results of a Phase IIb Multicenter Study
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(UroToday.com) The American Urologic Association (AUA) annual meeting included a late-breaking abstract session with a presentation by Dr. Behfar Ehdaie discussing results of a phase IIb multicenter study assessing MRI-guided focused ultrasound focal therapy for intermediate-risk prostate cancer. Radical whole-gland therapy for prostate cancer can lead to significant side effects, including a decline in erectile function and urinary continence. Patients with Grade Group 2 or 3 prostate cancer are often ineligible for active surveillance or experience early disease progression (40% within 5 years in ProtecT1) on active surveillance requiring radical therapy. Focal therapy has emerged as an alternative treatment with the goal to reduce side effects and maintain cancer control by targeting areas of known cancer with the prostate gland. Multicenter, retrospective studies have shown focal therapy for prostate cancer is safe and reported approximately 80% of men require no further prostate-cancer-directed treatment.2 This study investigated whether targeted focal therapy using ExAblate MRI-guided focused ultrasound can safely treat Gleason Grade Group 2/3 prostate cancer patients in a single-arm, multicenter phase IIb clinical trial.
AUA 2021: The IMPROVE Trial: Surgical Technique Remains the Most Important Factor Associated with Recovery of Urinary Continence After Radical Prostatectomy
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(UroToday.com) The American Urologic Association (AUA) annual meeting included a late-breaking abstract session with a presentation by Dr. Rafael Sanchez-Salas discussing results of the IMPROVE trial assessing surgical technique in the context of recovery of urinary continence after radical prostatectomy. Post-radical prostatectomy urinary incontinence is not uncommon. Both pelvic floor muscle training and duloxetine have been shown to be effective in improving post-radical prostatectomy urinary incontinence in retrospective series. This trial aimed to assess the efficacy of pelvic floor muscle training and duloxetine in urinary continence recovery after robot-assisted radical prostatectomy.
AUA 2021: NAXIVA - A Phase II Neoadjuvant Study of Axitinib for Reducing Extent of Venous Tumor Thrombus in Clear Cell Renal Cell Cancer with Venous Invasion: Translational Results
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(UroToday.com) The American Urologic Association (AUA) annual meeting included a late-breaking abstract session including a presentation by Dr. Sarah Welsh discussing translational results of the NAXIVA trial, a phase 2 neoadjuvant trial of axitinib for reducing the extent of venous tumor thrombus in clear cell renal cell cancer with venous invasion. Venous tumor thrombus extension occurs in 4-15% of cases of renal cell cancer, and although surgery is performed with curative intent, mortality is high (5-15%). The concept of neoadjuvant targeted therapy to downstage venous tumor thrombus prior to extirpative surgery is appealing in order to reduce the extent of the venous tumor thrombus surgery, and potentially reduce morbidity and mortality of the operation. The NAXIVA trial provided the first level II evidence in this patient group, assessing the response of venous tumor thrombus to axitinib. The primary endpoint, first presented at GU ASCO 2021, of the percentage of evaluable patients with an improvement in venous tumor thrombus according to the Mayo classification was positive at 26.58%. Additionally, 35.29% of patients had a change in the surgical approach to a less invasive option. Median percent reduction in venous tumor thrombus height was 21.49%. Response rate (RECIST) was 61.90% with stable disease, 14.29% with a partial response, and 9.52% with progressive disease. In this presentation, Dr. Welsh and colleagues presented the results of translational studies examining the role of the tumor microenvironment and response to axitinib.
AUA 2021: Long-Term Recurrence Free Survival Following UGN-101 Treatment for Low-Grade Upper Tract Urothelial Carcinoma
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(UroToday.com) The AUA 2021 virtual annual meeting included a late-breaking abstract session with a presentation by Dr. Karim Chamie discussing long-term recurrence free survival following UGN-101 treatment for low-grade upper tract urothelial carcinoma.
AUA 2021: Prospective Evaluation of 18F-DCFPyL PET/CT in Biochemically Recurrent Prostate Cancer: Analysis of 18F-DCFPyL Uptake in Possible Extra-Pelvic Oligometastases
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(UroToday.com) The American Urologic Association (AUA) annual meeting included a late-breaking abstract session with a presentation by Dr. Andrei Iagaru discussing the prospective evaluation of 18F-DCFPyL PET/CT in biochemically recurrent prostate cancer and the detection of extra-pelvic oligometastases. 18F-DCFPyl has been shown to have intense uptake in the bladder, kidneys, salivary glands, and lacrimal glands, with weak uptake in the liver, spleen, and bowel:
Urovant Sciences Presents Positive Ambulatory Blood Pressure Data Showing That GEMTESA® (vibegron) 75 mg in Overactive Bladder Was Not Associated with Statistically Significant or Clinically Meaningful Effects on Blood Pressure or Heart Rate
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- New data from dedicated ambulatory blood pressure study of patients with overactive bladder (OAB) showed once-daily treatment with GEMTESA® was not associated with statistically significant or clinically meaningful effects on blood pressure or heart rate
- Phase 3 EMPOWUR trial post-hoc subgroup analyses showed once-daily GEMTESA was associated with significantly reduced daily urgency episodes and micturitions in patients with OAB wet and dry (with and without urge urinary incontinence [UUI] per diary day, respectively) vs. placebo
- Presented at the virtual AUA 2021 annual meeting, these data further support safety and efficacy of GEMTESA for treatment of OAB in patients with symptoms of UUI, urgency, and urinary frequency
AUA 2021: Female Patients With Low-Grade Upper Tract Urothelial Carcinoma: Primary Chemoablation and Durability of Response in a Subgroup Analysis From the OLYMPUS Trial
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(UroToday.com) In this study by Linehan and colleagues, the authors focus on the outcomes of female patients from the OLYMPUS trial [NCT02793128], in which patients with low grade upper tract urothelial carcinoma (LG-UTUC) were treated with a novel reverse thermal gel containing mitomycin.
AUA 2021: Perioperative Intravesical Chemotherapy in Minimally Invasive Radical Nephroureterectomy for Upper Tract Urothelial Carcinoma: Low but Increasing Utilization Worldwide
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AUA 2021: A Phase II Randomized Clinical Trial Of Yoga In Men With Prostate Cancer
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(UroToday.com) In this study by Kaushik and colleagues, the authors explored the impact of yoga on men with newly diagnosed prostate cancer before and after prostatectomy. They found that yoga has important effects on quality of life (QoL), antitumor immune response, and inflammatory response.
AUA 2021: Novel Weekly Immunotherapy Dosing with Avelumab Tolerated During Bacillus Calmette-Guerin Induction Therapy: Initial Results of the ABC Trial
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(UroToday.com) In this presentation at the American Urologic Association (AUA) annual meeting, Dr. Kelly Stratton presents the initial results of the ABC trial, an open-label Phase Ib trial of BCG therapy in conjunction with avelumab for patients with BCG unresponsive non-muscle invasive bladder cancer (NMIBC). From a safety standpoint, they found that induction therapy with combined BCG and avelumab was safe and well-tolerated.
AUA 2021: Persistent Deficiencies in the Measurement and Reporting of Tobacco Use in Contemporary Genitourinary Oncology Clinical Trials
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(UroToday.com) In this late breaking abstract, Zhao and colleagues delved into the reporting of tobacco use in contemporary GU clinical trials and found that it is rarely collected or reported. Considering the impact of smoking on the development of GU malignancies, this is a deficiency that needs to be addressed.
AUA 2021: Initial Results from a Phase 1/2 Trial of Large Surface Area Microparticle Docetaxel for High-Risk Non-Muscle Invasive Bladder Cancer
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(UroToday.com) In this abstract by Max Kates and colleagues, they report on the safety and preliminary efficacy of a large surface area microparticle docetaxel (LSAM-DTX) for the treatment of patients with AUA high-risk non-muscle-invasive bladder cancer (NMIBC).