Key points:

- NIAGARA Trial - combination of chemotherapy and immunotherapy in the perioperative setting resectable muscle-invasive bladder cancer
- TiNiVO-2 Study - re-challenging patients with immunotherapy after progression on prior immunotherapy is not recommended
- PEACE-3 Study - combining enzalutamide with radium-223 in mCRPC and its impact on progression-free survival
- CONTACT-02 Study - cabozantinib with atezolizumab against a second novel hormonal therapy
In this episode of the Oncology Brothers podcast, we had the pleasure of welcoming Dr. Petros Grivas from Fred Hutch Cancer Center to discuss the key highlights from ESMO 2024, particularly focusing on genitourinary (GU) malignancies.
We kicked off the conversation with an in-depth analysis of the NIAGARA trial, which explored the combination of neoadjuvant chemotherapy and the PD-L1 inhibitor durvalumab in patients with muscle-invasive bladder cancer. Dr. Grivas emphasized the trial's significance, noting that it demonstrated improved event-free survival and overall survival without compromising patient safety. This trial is poised to change clinical practice for cisplatin-eligible patients.
Next, we shifted our focus to the TiNiVO-2 study, which addressed the question of re-challenging patients with immunotherapy after progression on prior checkpoint inhibitors. Dr. Grivas highlighted that both TiNIiO2 and CONTACT-03 trials showed no benefit from re-challenging with immunotherapy, suggesting that alternative treatments like TKI should be considered in these cases.
In the second half of the episode, we discussed two important studies in prostate cancer. The first was the PEACE-3 trial, which evaluated the combination of enzalutamide and radium-223, showing improved radiographic progression-free survival. However, Dr. Grivas pointed out the challenges in applying these findings to modern patient populations who often have prior exposure to novel antiandrogens.
Finally, we covered the CONTACT-02 trial, which compared cabozantinib with atezolizumab with a second novel hormonal therapy. While the overall survival was not significantly different, there was a notable benefit for patients with liver metastases, indicating a potential niche for cabozantinib in difficult-to-treat populations.
Overall, ESMO 2024 presented exciting advancements in GU malignancies, and we appreciate Dr. Grivas for sharing his insights. We encourage our listeners to check out our other highlights from the conference, covering breast cancer, lung cancer, and GI malignancies. Thank you for tuning in to the Oncology Brothers podcast!