Compiled by Magnolia Ark Team | Urothelial carcinoma (UC) is a multi-original malignant tumor originating from the urothelial, including renal pelvic carcinoma, ureteral carcinoma, bladder cancer and urethral cancer . It is the most common urinary system tumor. For advanced urothelial carcinoma, chemotherapy is poor, and targeted and immunotherapy for may prolong the patient's survival. At present, innovative therapies such as Teccentriq, Opdivo, Bavencio, Keytruda, Trodelvy, and Padcev have been proven to be applicable to advanced urothelial carcinoma .
But the researchers are not satisfied with this. In order to further prolong the survival of patients with advanced urothelial cancer, the researchers focused on targeted combined immune therapy. In recent years, several studies have confirmed that the combination therapy of targeted combined immunity has performed well in the field of treatment of advanced urothelial carcinoma. Among them, the combination treatment plan of Padcev and Keytruda has shown outstanding results in the first-line treatment of advanced urothelial carcinoma.
▲Source: Maker Post
Padcev+Keytruda First-line treatment of advanced urothelial cancer has significant effect
Padcev (enfortumab vedotin, EV) is an antibody drug conjugate (ADC) targeting Nectin-4 (a type I membrane protein). In December 2019, Padcev was approved by the U.S. Food and Drug Administration (FDA) for the treatment of locally advanced or metastatic urothelial carcinoma, becoming the first ADC drug approved for the treatment of urothelial carcinoma. In May 2021, Padcev was given priority review by Japan, significantly extending the survival of urothelial carcinoma. Recommended reading: The new ADC drug Padcev has received priority review in Japan, significantly extending the survival of urothelial cancer
In February 2020, the FDA approved the breakthrough drug qualification (BTD) for the combination of Padcev and Keytruda to treat patients with locally advanced or metastatic urothelial cancer (UC) who cannot receive cisplatin chemotherapy in first-line treatment [1].
Recently, a study published in the international medical journal Journal of Clinical Oncology revealed the effect of Padcev and Keytruda combined drug regimens in patients who do not apply cisplatin.
▲Photo source: Reference source [2]
A total of 46 patients with advanced urothelial carcinoma were included in the study. After Padcev + Keytruda combined treatment, the objective response rate of in the patient was 73.3%, the complete response rate was 15.6%, and the partial response rate was 57.8% ; at the follow-up time of 20.0 months, the median duration of response (DOR) was 25.6 months ; at the follow-up time of 24.9 months, the median progression-free survival (PFS) of was 12.3 months, and the median survival was 26.1 months .
▲Photo source: Reference source [2]
Erdafitinib+Cetrelimab exponentially increases objective response rate
In addition, the combination treatment regimen of the pan-FGFR inhibitor Erdafitinib (erdatinib) and the PD-1 inhibitor Cetrelimab (cetrelimab, CET) can also be used as a treatment option for advanced urothelial carcinoma (mUC) with FGFRa (mutation/fusion).
Phase 1b/2 NORSE study (NCT03473743) published at the virtual conference of the European Society of Medical Oncology (ESMO) 2021 evaluated the effectiveness of Erdafitinib + Cetrelimab in patients with locally advanced or metastatic urothelial carcinoma that is not suitable for cisplatin chemotherapy and is harboring fibroblast growth factor receptor (FGFR) FGFR3 or FGFR2 gene alteration. The results of the
study showed that the objective response rate of Erdafitinib+Cetrelimab was 68%, the complete response was 21%, and the partial response rate was 47%, while the objective response rate of the control group was only 33%.
▲Photo source: Reference source [3]
In short, the emergence of targeted and immunotherapy has significantly prolonged the survival of patients with urothelial cancer. However, each treatment of has its indication requirements, and it is even more necessary for patients with urothelial cancer to choose authoritative experts to diagnose and treat, determine individualized treatment plans, and improve prognosis .
As a leader in domestic and overseas medical service institutions, Magnolia Ark has in-depth cooperative relationships with authoritative urothelial cancer treatment centers in Japan, the United States, the United Kingdom and other countries. It can make appointments for patients with urothelial cancer for treatment, formulate individualized treatment plans, and provide patients with one-stop medical treatment and remote consultation services. Friends in need can contact the editor through private messages or comments.
Reference source:
[1]Astellas and Seagen Announce Positive Topline Results For PADCEV® (enfortumab vedotin-ejfv) with KEYTRUDA® (pembrolizumab) as First-Line Treatment for Advanced Urothelial Cancer
https://www.prnewswire.com/news-releases/astellas-and-seagen-announce-positive-topline-results-for-padcev-enfortumab-vedotin-ejfv-with-keytruda-pembrolizumab-as-first-line-treatment-for-advanced-urothelial-cancer-301592924.html
[2]Hoimes CJ, Flaig TW, Milowsky MI, Friedlander TW, Bilen MA, Gupta S, Srinivas S, Merchan JR, McKay RR, Petrylak DP, Sasse C, Moreno BH, Yu Y, Carret AS, Rosenberg JE. Enfortumab Vedotin Plus Pembrolizumab in Previously Untreated Advanced Urothelial Cancer. J Clin Oncol. 2022 Aug 30:JCO2201643. doi: 10.1200/JCO.22.01643. Epub ahead of print. PMID: 36041086.
[3]Janssen Presents Results from Phase 1b/2 NORSE Study in Patients with Metastatic or Locally Advanced Urothelial Carcinoma Treated with BALVERSA® (erdafitinib) in Combination with Cetrelimab, a PD-1 Inhibitor | Johnson & Johnson
https://www.jnj.com/janssen-presents-results-from-phase-1b-2-norse-study-in-patients-with-metastatic-or-locally-advanced-urothelial-carcinoma-treated-with-balversa-erdafitinib-in-combination-with-cetrelimab-a-pd-1-inhibitor
