asco g.u. 2014 lawrence h. einhorn
DESCRIPTION
ASCO G.U. 2014 Lawrence H. Einhorn. TOPICS Testis cancer – nothing new July 1, 2014 JCO (correspondence) – Albany and Einhorn: Pitfalls in low level elevations of AFP Bladder cancer PD-L1 Renal cell cancer Ranking of treatment options Nivolumab PD-1 Prostate cancer Adjuvant Docetaxel - PowerPoint PPT PresentationTRANSCRIPT
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ASCO G.U. 2014
Lawrence H. Einhorn
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TOPICS• Testis cancer – nothing new
• July 1, 2014 JCO (correspondence) – Albany and Einhorn: Pitfalls in low level elevations of AFP
• Bladder cancer
• PD-L1
• Renal cell cancer
• Ranking of treatment options
• Nivolumab PD-1
• Prostate cancer
• Adjuvant Docetaxel
• Enzalutamide
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Inhibition of PD-L1 by MPDL3280A<br />leads to clinical activity in<br />patients with metastatic urothelial bladder cancer (UBC)
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MPDL 3280A PD-L1 I IN METASTATIC BLADDER CA
• 65 patients entered
• 71% received 2 or more prior therapies
• 17 of 65 (26%) response rate, but 13 of 30 (43%) if PD-L1 positive (2+ or 3+) by IHC, including 2 C.R.s
• Genentech phase II study to enroll 326 (!!) patients
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Renal Cell Cancer
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Algorithm for Clear Cell RCC Therapy
Presented By Michael Atkins at 2014 ASCO Annual Meeting
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Nivolumab for metastatic renal cell <br />carcinoma (mRCC): results of a randomized, dose-ranging phase II trial
Presented By Robert Motzer at 2014 ASCO Annual Meeting
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Phase II study design
Presented By Robert Motzer at 2014 ASCO Annual Meeting
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Key inclusion criteria
Presented By Robert Motzer at 2014 ASCO Annual Meeting
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NIVOLUMAB IN METASTATIC RENAL CELL CA
• 168 patients entered; all received prior therapy and 70% 2 or more including VEGF TKIs (98%) MTOR inhibitors (38%) and immunotherapy (24%)
• 35 of 168 (21%) response rate; 19 of these 35 (54%) remissions were 12+ month duration
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Overall survival
Presented By Robert Motzer at 2014 ASCO Annual Meeting
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PROSTATE CANCER
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ASCO 2004, abstracts 3 and 4<br />mCRPC
2 months improvement in OS
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<br /><br />E3805<br />CHAARTED: ChemoHormonal Therapy versus Androgen Ablation Randomized Trial for Extensive Disease in Prostate Cancer
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E3805 – CHAARTED Treatment
Men with Metastatic Hormone Sensitive
Prostate Cancer
ADT + Docetaxel x 6 cycles
ADT Alone
ADT allowed up to 120 days prior to randomizationNo Intermittent ADT allowed
Primary Endpoint: Overall SurvivalSecondary Endpoints: PSA response rate, Time to progression, Toxicity QOL.
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Primary endpoint: Overall survival
N=790
13.6 months
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Secondary Endpoints
Presented By Christopher Sweeney at 2014 ASCO Annual Meeting
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Drugs that prolong OS for CRPC
Presented By Michael Morris at 2014 ASCO Annual Meeting
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PREVAIL– Study Design
Men with Metastatic Castration
Resistant Prostate Cancer
Chemo-naïve N= 1717
EnzalutamideN=872
PlaceboN=845
Co-Primary Endpoint: Radiographic PFS Overall Survival
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PREVAIL Was Halted at the Interim Analysis for Significant Benefit with Enzalutamide
Presented By Andrew Armstrong at 2014 ASCO Annual Meeting
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Enzalutamide Prolonged Radiographic <br />Progression-Free Survival
Presented By Andrew Armstrong at 2014 ASCO Annual Meeting
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Enzalutamide Reduced Risk of Death by 29%
Presented By Andrew Armstrong at 2014 ASCO Annual Meeting
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Enzalutamide Delayed Time to PSA Progression
Presented By Andrew Armstrong at 2014 ASCO Annual Meeting
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SUMMARY
•Testis cancer•Bladder cancer •Renal cell cancer •Castrate resistant prostate
cancer