Min Yuen Teo 張鳴元

How modern therapies dislodged chemotherapy in advanced urothelial carcinoma

Retrospective real-world clinicogenomic study in @Nature 5893 pts with mCRPC 37% HRR pathogenic variants. 13% BRCA1/2. 389 received olaparib: BRCA2: median OS 17.5 mo BRCA1: 8.1 mo HR 2.23 (P=0.008) BRCA1 clearly worse. Within BRCA2, subtype defines benefit ⚠️ BRCA2 loss: median OS 24.3 mo HR 0.42 (P<0.001) This is intra-BRCA functional heterogeneity ‼️ Not all BRCA alterations are biologically or therapeutically equivalent. rdcu.be/e6mxn @OncoAlert

This is a massively important trial —you rarely see this. Important for the field and for the region. It's time to reflect on PD1 dosing… ! Bravo @VanitaNoronha et al! @OncoAlert @JCO_ASCO @TataMemorial @ASCO

Pembrolizumab combined with platinum-based chemotherapy showed a 39.4% response rate and manageable toxicity as a potential first-line treatment for advanced penile squamous cell carcinoma. ja.ma/3XfSa8H

JUST IN: 2 Belzutifan (HIF2 inhibitor) phase III trials POSTIVE for Primary Endpoint in Renal Cell Carcinoma: LITEPSPAK022 (adjuvant) + LITESPARK011 (metastatic, post PD1). BIG NEWS for GU Oncology + Kidney Cancer patients! tinyurl.com/2hywykhk tinyurl.com/mwawkbz7

2/2 this becomes standard of care here. Questions-How would this perform in a cisplatin eligible population? Better? Can ctDNA help? How many cycles are needed? B15 & VOLGA can help here.Finally, bladder sparing trials are needed to address the need for surgery @OncoAlert #ESMO25

1/2 KN905 Enfortumab Vedotin + Pembro continues to transform bladder cancer in spectacle fashion. In cisplatin ineligible operable disease it beats cystectomy with EFS HR 0.4, OS HR 0.5. pCR of 57% is much ⬆️ than anything before #ESMO25 pCR> 50% questions unselected surgery

Wonderful talk by @PGrivasMDPhD on neoadj #bladdercancer treatment w updates #NIAGARA , role of ctDNA and ongoing neoadjuvant/adjuvant trials👉his take home message for our clinical practice. #ESMO25 #ESMOAmbassador @OncoAlert @myESMO

The bar is raised! Periop 🥪 EVP for cis ineligible (90%) or refusing (10%) MIBC = new SOC *KN905/EV302* ✅pT0 rate highest ever in MIBC 57% ITT, 65% cystectomy sub-pop ✅2yr EFS & OS on par w DDMVAC in cis eligible -cis eligible EVP🥪 trial *KNB15/EV304* readout awaited #ESMO25

Renal cancer 1st line randomised PII KMUA3B #ESMO25 with lenavatinib/pembro as the control (hard to beat with RR>80%). Len/pem/belzutifan showed good PFS (HR0.45) ✅ which may lead to a positive RIII (LS12) which is ongoing. TIGIT 🛑 & LAG3 🛑 were disappointing again @OncoAlert

🚨 New data at #ESMO25! Outcomes with enfortumab vedotin + pembrolizumab (EV/P) in metastatic urothelial carcinoma harboring FGFR3 or ERBB2 alterations. Presented by @MichalSternsch & @dr_aggen — Poster #3102P 
📍Memorial Sloan Kettering Cancer Center | #MSKCC | @MSK_DeptofMed
#BladderCancer #Oncology

RAMPART #ESMO25 adjuvant durvalumab/tremelimumab delays DFS in adjuvant RCC vs supportive care. This is confusing as ipi/nivo did not hit DFS. Durvalumab monotherapy data will help on component parts. Benefit seems confined to good risk. Adjuvant pembro has OS here. @OncoAlert

#RenalCancer #Epidemiology Update: #Incidence, #Mortality, #Survival, #GeneticPredisposition, and #RiskFactors • 🌍 434,840 cases and 11,953 deaths in 2022 • 📈 Incidence projected to increase by +72% by 2050 • 📈 Mortality projected to increase by +96% by 2050 • 📊 5-year survival: 66–75% • 🧬 Specific genetic background and hereditary renal cancer syndromes • 🎯 Review of modifiable and non-modifiable risk factors @_alelarcher @Ric_Campi @FreddieBray_ @LauraBukavinaMD @EJonasch @AhJemal @LauraMarandino @vmollica7 @KidneyCancerDoc @grantissimus @MaxineGBTran @uretericbud 👉 buff.ly/i2tZOHi

🚨 New in European Urology: Consolidative surgery after #EnfortumabVedotin +/– ICI in advanced urothelial carcinoma: ✅ 82% downstaging ✅ 43% ypT0N0 ✅ 79% stopped systemic therapy ✅ 89% DFS in curative group 📄 buff.ly/RFs0J5N #BladderCancer #Immunotherapy #Urology

What a great summary on treatment of #Oligometastatic #ProstateCancer ! Congrats @VedangMurthy @drmaneesh_singh @piet_ost Good learning for every Resident and Senior Faculty! 💪🏻💪🏻

#ASCO25 Final results of IO-based combinations in mRCC are in! See below and subsequent posts for thoughts. Video discussing these data coming soon from @OncoAlert...

This is a major story from #ASCO25. Randomized phase 3 trial of time of day of immunotherapy infusion. Randomized to infusion before or after 3pm. Early infusion far superior: PFS 11.3 vs 5.7 HR 0.42, OS HR 0.45! Impactful, pragmatic, not costly. This should be a bigger story.

🚨 #ASCO25 plenary NIVOPOSTOP: 1st DFS win in 20+ yrs for resected high-risk LA-SCCHN ➡️ n=666, NIVO + CRT vs CRT alone 🎉 3-yr DFS: 63.1% vs 52.5% 💥HR 0.76 (p=0.034) ⚠️ mild Gr4 AEs ⬆️ w/ NIVO (13.1% vs 5.6%) ✅ New adjuvant IO standard emerging? #hnscc #Immunotherapy #RadOnc

What this means? In patients staged with PSMA-PET and treated with Augmented/intensified WPRT RT, the incremental benefit of adding abiraterone may be modest We hope this adds nuance to personalising Rx for HR Ca Prostate—balancing benefit, cost, access, and toxicity.

Dr Hikmat Al-Ahmadie highlights markers in #urothelialcarcinoma which may be therapeutically targeted including MMRd/MSI, FGFR3, and antibody-drug conjugate (ADC) markers such as NECTIN-4 and HER2 #gupath @GU_Path_Society #USCAP2025