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Partnering up with Abiraterone Acetate – Potentials for a Harmonious Relationship
Published 03 May 2021
Abiraterone acetate has demonstrated benefit across the metastatic prostate cancer spectrum when combined or layered on conventional androgen deprivation therapy. Whether it be metastatic castration-sensitive (mCSPC) or metastatic castration-resistant prostate cancer (mCRPC) in either the pre-or the post-docetaxel setting, the overall survival benefit is certain.
1-4 Attempts to advance to the next level with additional agents added to abiraterone acetate, in the first-line mCRPC setting, have been met with mixed results. At this time, other than the continuing foundation of androgen deprivation therapy, there is no therapeutic agent regulatory approved for combination with abiraterone acetate.
Published 01 April 2021
Adjuvant therapy trials for urothelial carcinoma have traditionally been challenging to perform. Radical cystectomy is a significantly morbid procedure that leads to high complication and readmission rates. Hence, many patients are not fit to receive any adjuvant therapy after definitive local therapy due to a compromised health situation. At this time, neoadjuvant chemotherapy is still the definitive standard.
1 However, not all patients receive neoadjuvant therapy for a multitude of reasons. For those who did not receive neoadjuvant cisplatin combination chemotherapy, common sense warrants strong consideration of adjuvant therapy as long as a patient is fit and interested.
However, we have extremely limited evidence on what to do if a patient has residual muscle invasive disease after prior receipt of neoadjuvant combination cisplatin-based chemotherapy. This is clearly an unmet need population due to the very poor prognosis.
Published 01 March 2021
It’s now been 3.5 years since I last wrote anything about testicular germ cell tumors and ongoing clinical trials.
1 Although we still cure most men afflicted with this disease, we have not made any major new therapeutic advancements since I wrote that last article. Approximately, 15-20% of patients with metastatic germ cell tumors will relapse following initial chemotherapy. Even in this situation, approximately 50% can still be cured with salvage treatments, either with more conventional cisplatin-based chemotherapy or with high-dose chemotherapy and autologous stem cell rescue.
2-4 However, patients with cisplatin-refractory disease or progressive disease following high-dose salvage chemotherapy and autologous stem cell rescue, harbor an extremely dim prognosis. In these situations, palliative chemotherapy, with regimens containing oxaliplatin, is limited in efficacy, and targeted biologic therapies have also shown limited efficacy.
Sacituzumab Govitecan – Another Antibody Drug Conjugate Carving out a Path in Genitourinary Oncology
Published 01 February 2021
I have previously discussed the use of antibody-drug conjugates for selective tumor cell intensification of urothelial carcinoma therapy in a Urotoday Clinical Trials Portal article.
1 Similarly, I’ve also focused on enfortumab vedotin before, and enfortumab vedotin is now FDA approved on the accelerated pathway for patients with locally advanced or metastatic urothelial carcinoma in the post-platinum chemotherapy and post-PD-(L1) antibody therapy setting.
2 Yet, even as new data continues to emerge on the use of enfortumab vedotin in various settings, we should take time to evaluate the development of other promising antibody-drug conjugates.