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Critical Trial Review in GU Oncology From ASCO 2017

Interview with Guru Sonpavde MD

‘Filmed by PracticeUpdate with permission for inclusion on Uro Onco. More information and additional ASCO coverage can be found at www.practiceupdate.com

Interview transcript

Dr. Farzanna Haffizulla: 

Thank you for joining us for this PracticeUpdate. I’m Dr. Farzanna Haffizulla. Joining me today is Dr. Guru Sonpavde. Dr. Sonpavde is Director of the Bladder Cancer Center at the Dana Farber Institute. Excellent to have you here.

Dr. Guru Sonpavde:

Thank you.

Dr. Farzanna Haffizulla: 

So, I wanted to talk about the biggest news coming out of ASCO this year is the role of abiraterone, actually, in metastatic hormone-sensitive prostate cancer. Does this become a new standard of care based on the results of STAMPEDE and LATITUDE or is there still a role for docetaxel?

Dr. Guru Sonpavde:

Yes, I think that essentially adding abiraterone and prednisone to metastatic castration-sensitive prostate cancer is going to become a standard of care based on these results in the near future. I don’t think you could say this is the only standard of care. I think docetaxel remains a standard of care, and at this point, we would have to discuss these data with the patients and see which therapy they might prefer, either docetaxel, which is only 6 cycles, of course. So it’s a shorter duration of treatment or the abiraterone/prednisone is given continuously every day until progression of disease, which would be a longer duration of treatment, which could be between 2 and 3 years on an average.

Dr. Farzanna Haffizulla: 

Yes. Absolutely. Now, you’re also leading a number of interesting investigator-initiated trials. One examining the sequence of sunitinib and avelumab in patients with advanced kidney cancer. Can you tell us more about the study, and how it may potentially impact the landscape of therapy of this disease?

Dr. Guru Sonpavde:

Right, so the rationale behind this trial is that we believe a lot of patients in the community are not going to be candidates for aggressive combination therapy in the first-line setting. So, we have all these trials, phase 3 trials, examining a combination of VEGF-inhibition and PD-1 inhibition or PD-1 inhibition plus CTLA4 inhibition, but in the community really there are a lot of patients who have a performance status that’s poor. They’re not going to be candidates for aggressive combinations, so that was the rationale for this trial, which is examining sequencing of sunitinib followed by avelumab, which is a PD-L1 inhibitor at progression versus avelumab followed by sunitinib at progression.

So, the study is a randomized phase 2 trial. It will provide insights regarding sequencing. It is not a definitive phase 3 trial, but it will provide useful insights. We will also have biomarker studies of baseline tumor tissue PD-L1 expression, and we will do correlative circulating immune studies at three time points, so we will get useful data from this study.

Dr. Farzanna Haffizulla: 

Excellent. When do you expect to have an interim analysis, perhaps, or is this very early phase right now in the process?

Dr. Guru Sonpavde:

Right. So, this is a randomized phase 2 trial that will accrue 150 patients. It just got activated, so it is not done in separate stages because it’s a small trial. It’s somewhat a modest sized trial, 150 patients, so I think we will report it when it will essentially complete accrual.

Dr. Farzanna Haffizulla: 

Of course. That makes sense. Absolutely. Thank you, again, for all the great work that you’re doing. We’re looking forward to hearing more from you, and to having you back on PracticeUpdate.

Dr. Guru Sonpavde:

Thank you.

Dr. Farzanna Haffizulla: 

To our viewers, thank you again for joining us for this PracticeUpdate. I’m Dr. Farzanna Haffizulla.

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