COR2ED - Oncology Medical Conversation

Dr Tanya Dorff, a Medical Oncologist from the City of Hope Comprehensive Cancer Center and Dr Neeraj Agarwal, Medical Oncologist and Director of the Genitourinary Oncology Program at the Huntsman Cancer Institute, University of Utah in the United States discuss the efficacy and safety data of combination therapy with PARPi and NHAs, incorporating the latest data presented at ASCO GU 2023 and the impact for the treatment of patients with mCRPC in this GU CONNECT podcast.

In this podcast, the experts discuss the updated survival analysis from the PROPEL study of olaparib and abiraterone which demonstrated a benefit in an all-comer mCRPC population and the second interim analysis from the MAGNITUDE study which showed a benefit of niraparib plus abiraterone in mCRPC patients with homologous recombination repair alterations. They also discuss the differing trial results and how these compare to the most recent data presented from the TALAPRO-2 trial of talazoparib plus enzalutamide which showed a benefit in a biomarker unselected population.

The experts consider how this combination therapy may be implemented in clinical practice in the future pending regulatory approval of the combinations.

Prof. Dr James Harding, Medical Oncologist at Memorial Sloan Kettering Cancer Center and Prof. Dr Sammy Saab, Gastroenterologist and Transplant Hepatologist at the David Geffen School of Medicine, both from the USA, discuss the treatment options for advanced hepatocellular carcinoma (HCC) patients who are not eligible for immunotherapy (IO) first line.

In this podcast, the experts give an overview of the current systemic treatment options for patients by looking into the results from different clinical trials and current guidelines, as the field is rapidly evolving since 2017. They discuss the patient cohorts who are not eligible for IO in first line, such as patients with underlying auto-immunity, impaired organ function and patients who decline IO.

The experts discuss the efficacy and safety data from the SHARP and Asia Pacific trials of sorafenib and from the REFLECT trial of lenvatinib, which are both tyrosine kinase inhibitors (TKIs) and available for the aforementioned patient cohorts. They also present their approach to toxicity management for patients receiving those TKIs.

Dr Neal Shore, Uro-Oncologist and Chief Medical Officer for Genesis Care and Urology and Surgical Oncology in the United States and Dr Elena Castro, Medical Oncologist at Hospital Universitario 12 de Octubre in Madrid, discuss clinical implementation of PARP inhibitors and novel hormonal agent (NHA) combinationtherapy for patients with mCRPC, providing both a US and EU perspective.

In this podcast, the experts discuss efficacy and safety data from the PROPEL study of olaparib and abiraterone which demonstrated a benefit in an all-comer mCRPC population and data from the MAGNITUDE study which showed a benefit of niraparib plus abiraterone in a biomarker positive mCRPC population. The experts discuss the differing trial results and how these compare to the TALAPRO-2 trial of talazoparib plus enzalutamide.

They discuss the value of genetic testing considering these results and debate whether an all-comer mCRPC patient population should be treated with a PARP inhibitor plus NHA combination or whether treatment should be determined based on HRR alterations. 

The experts consider how this combination therapy may be implemented in clinical practice in the future including how to manage patients who are already receiving a NHA prior to becoming castration resistant.

Dr Neal Shore, Uro-Oncologist and Chief Medical Officer for Genesis Care and Urology and Surgical Oncology in the United States and Dr Elena Castro, Medical Oncologist at Hospital Universitario 12 de Octubre in Madrid, discuss clinical implementation of PARP inhibitor monotherapy for prostate cancer patients, providing both a US and EU perspective.

In this podcast, the experts discuss the key efficacy and safety findings from the olaparib registration study, PROfound, and the TRITON-2 study which led to accelerated approval for rucaparib. They also discuss the recent data from the rucaparib confirmatory phase 3 trial, TRITON 3 and based on the results of these studies, debate are all PARP inhibitors the same and can the results be extrapolated from one PARP inhibitor to another.

The timing of treatment with PARP inhibitors versus taxanes is also explored.

Genetic testing is amongst the topics covered, including when to consider germline versus somatic testing and the impact of various homologous recombination repair alterations on efficacy.

Join Lead Nurse Andreia Fernandes and Clinical Nurse Specialist Jo Pearson as they explain how to help patients navigate the side effects of systemic therapies in endometrial carcinoma. Specialist nurses have a critical role helping women stay on treatment and at home for as long as possible. They discuss their privileged position supporting women with endometrial carcinoma and how they continue to educate and advocate for women in a fast-changing therapeutic environment.

Join world-renowned gynaecological oncology experts Dr Domenica “Ketta” Lorusso and Dr Mansoor Mirza as they explore the changing landscape of systemic treatment in endometrial carcinoma. Single-agent immunotherapies (pembrolizumab and dostarlimab), and now immunotherapy and antiangiogenic therapy combinations (pembrolizumab and lenvatinib), are transforming treatment pathways, with OS benefits in the second-line now achievable. They offer tips for managing the toxicity of these novel therapeutic options and set the stage for 2023, a year which promises a paradigm shift in the use of systemic treatments in this once underserved malignancy.

This episode, covers the highlights on colorectal cancer from ASCO GI 2023.  Prof. Andrea Sartore-Bianchi (Niguada Cancer Center, Milan, Italy) and Prof. Shubham Pant (MD Anderson Cancer Center, Houston, TX, USA) discuss a number of key abstracts from the meeting and their implications for clinical practice.

The experts start by discussing the SUNLIGHT trial which studied the use of trifluridine/tipiracil plus bevacizumab as third-line treatment in refractory colorectal cancer.  The discussion then moves on to a trial which evaluated the kinetics of post operative circulating cell-free DNA and its impact on minimal residual cell detection in patients with stage I-III colorectal cancer. 

The third abstract the experts discussed was a phase I trial which study botensilimab plus balstilimab in MSS colorectal cancer patients. Finally they discuss the long term results of NRG-GI002, a phase 2 trial which looked at the use of total neoadjuvant therapy in locally advanced rectal cancer. 

This episode, covers the highlights on gastroesophageal, gastric and gastroesophageal junction (GEJ) cancer from ASCO GI 2023.  Dr Nataliya Uboha (University of Wisconsin, USA) and Dr Efrat Dotan(Fox Chase Cancer Center, USA) discuss a number of key abstracts from the meeting and their implications for clinical practice.

 The experts start by covering a number of metastatic studies.  First of all, they discuss SPOTLIGHT, a study which investigated the novel agent zolbetuximab as first line treatment in patients with claudin-18.2+/HER2 locally advanced unresectable or metastatic gastroesophageal cancer.  Next they discuss Rationale 305, a study that looked at the activity of tislelizumab in combination with chemotherapy versus chemotherapy alone in patients with PD-L1 positive tumours.  They also discussed the three-year follow up results from CheckMate 649, looking at nivolumab plus chemotherapy vs chemotherapy alone as first-line treatment for advanced gastroesophageal cancer.  The discussion then moves on to INTEGRATE IIa, a study comparing regorafenib with placebo in refractory advanced gastroesophageal cancer. 

In this podcast, Prof. Jonathan Trent and Prof. Robin Jones discuss what’s new in the patient management in sarcoma from CTOS 2022. The Connective Tissue Oncology Society is an international group of physicians and scientists with a primary interest in the tumours of connective tissues. With nearly 600 attendees, 10 sessions specific for sarcoma, and over 300 posters, CTOS 2022 took place between November 16 and 19 in Vancouver, BC, Canada. Clinical practice and patient management highlights covered in the podcast include insights from the DEFI study on desmoid tumour, the REECUR study for Ewing sarcoma, and the ENLIVEN study for gastrointestinal stromal tumor (GIST). In addition, early studies with potential clinical impact are discussed.

Prof. Jonathan Trent is Associate Director for Clinical Research, the Director of the Bone and Soft-tissue Sarcoma Group and Medical Director of the Precision Medicine Initiative at the Sylvester Comprehensive Cancer Center in the University of Miami Health System, Miami, FL, USA. Prof. Robin Jones is Head of the Sarcoma Unit at The Royal Marsden NHS Foundation Trust, London, UK.

Prof. Thomas Powles, a Medical Oncologist from Barts Cancer Centre in the UK and Dr Friederike Schlürmann a Medical Oncologist from University Hospital of Brest and Quimper in France, discuss the clinical implementation of targeted and immunotherapies for advanced renal cell carcinoma (RCC).

In this podcast, the two experts discuss data from key trials CHECKMATE 214 (ipilimumab and nivolumab), KEYNOTE 426 (axitinib and pembrolizumab), CHECKMATE 9ER (cabozantinib and nivolumab), CLEAR (Lenvatinib and pembrolizumab) and COSMIC 313 (cabozantinib plus nivolumab and ipilimumab) and the implications for clinical practice.

They also discuss management of toxicities associated with combination treatments, including dosing strategies to ensure the patient remains on optimal treatment and improved education for patients and clinicians so that they recognise side effects and how to manage them.