Letter from the Editor

Dear Reader,

A very warm welcome to you. I am delighted to present you with the most recent data in urologic oncology, right from ASCO’s 2022 Genitourinary Cancers Symposium.

Personalized medicine firmly expands in GU cancers. Surprisingly, some targeting treatments seem to have a broader realm: Ever since 2018, looking for homologous recombination repair (HRR)-deficient prostate cancers may lead to treatment benefit with a PARP inhibitor, but now there seems to be benefit combining abiraterone with olaparib even in non-HRR-deficient metastatic prostate cancers – according to the PROpel study. In a similar setting, niraparib did not seem to show the same results. There’s certainly need for further insight.

Should we continue combined androgen blockade even when progression warrants chemotherapy? The PRESIDE study provides evidence in favor (I’ll leave the questions of clinical relevance versus economic aspects to you to discuss). Interestingly, PSMA-PET may actually be of predictive value when deciding between chemotherapy and isotopes.

PARP inhibitors may also play a role in urothelial cancer treatment, provided there is HRR deficiency. Could there be a difference between the action of individual PARP inhibitors in urothelial cancers? Rucaparib seems to provide benefit in maintenance after first-line chemotherapy, whereas olaparib and niraparib do not seem to do so…

Check out interesting strategies in neoadjuvant treatments of high-risk renal and bladder cancers, escalation to double immune checkpoint inhibition in urothelial cancers not responding to nivolumab monotherapy, efficient conjugates, etc. Not yet implementable next Monday, but intriguing and potentially promising approaches.

I hope you enjoy reading our report.

Please also give a thought and all possible support to our colleagues in Ukraine who face these very difficult times.

 

Yours, sincerely

Stefan Rauh



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Posted on 8 April, 2022