Dr Grivas on Updated Data in the Treatment of Metastatic/Unresectable Urothelial Carcinoma

Petros Grivas, MD, PhD, physician, professor, Clinical Research Division, Fred Hutchinson Cancer Center; professor, Division of Hematology and Oncology, University of Washington (UW) School of Medicine, clinical director, Genitourinary Cancers Program, UW Medicine, discusses updated data and key advancements in care that were read out in 2023 for the treatment of patients with metastatic or unresectable urothelial carcinoma.

Grivas shared these updates in care at an OncLive® State of the Science Summit™ (SOSS) on genitourinary cancers, which he chaired. In 2023, significant strides and advancements were made in the realm of advanced urothelial carcinoma management, with notable developments emerging from the 2023 ESMO Congress, Grivas begins. During the SOSS, Grivas presented updates on recent data concerning urothelial carcinoma and offered insights into the evolution of treatment approaches for patients with this disease over the past few decades.

Platinum-based chemotherapy, particularly cisplatin-based regimens, has long been the mainstay for the frontline management of advanced urothelial carcinoma, he expands. However, the treatment paradigm shifted with the emergence of pivotal findings from 2 key trials: the phase 3 CheckMate 901 trial (NCT03036098) and the phase 3 EV-302/KEYNOTE-A39trial (NCT04223856), both of which have challenged the established standard of care (SOC) for patients with urothelial carcinoma, Grivas explains.

Furthermore, in June 2020, the results from the phase 3 JAVELIN Bladder 100 trial (NCT02603432) were unveiled, he adds. The randomized JAVELIN Bladder 100 study compared avelumab (Bavencio) plus best supportive care (BSC) vs BSC alone in patients with locally advanced or metastatic urothelial carcinoma who had attained stable disease following platinum-based chemotherapy, Grivas continues. The trial established maintenance therapy with avelumab as the SOC in several countries for patients who did not experience disease progression during platinum-based chemotherapy, he concludes. In comparison, the more recent CheckMate 901 study evaluated the use of a regimen consisting of frontline nivolumab (Opdivo) plus chemotherapy vs chemotherapy alone in cisplatin-eligible patients with unresectable or metastatic urothelial carcinoma.