Following the 2025 ASCO Genitourinary (GU) Cancers Symposium, Dr. Guru P. Sonpavde sat down for an interview with CURE® to debate genetic testing and the significance of precision drugs in most cancers care.
Sonpavde, the medical director of Genitourinary Oncology, an assistant director of the Scientific Analysis Unit, and the Christopher Ok. Glanz Chair for Bladder Most cancers Analysis on the AdventHealth Most cancers Institute, positioned in Orlando, Florida, emphasised the significance of higher understanding how genetic mutations affect the therapy of most cancers care, significantly in GU cancers, and went on to debate the potential of precision care.
Glossary:
Minimal residual illness: the presence of a really small variety of most cancers cells that stay within the physique after therapy, even when the affected person is in remission.
Circulating tumor DNA (ctDNA): DNA that breaks away from most cancers cells and enters the bloodstream
Transcript:
Precision drugs nonetheless has a methods to go. As we all know, we use biomarkers in prostate and bladder most cancers; clearly genomic or germline alterations in BRCA1 and BRCA2 has had a huge impact on the usage of PARP inhibitors. In fact, we additionally know that the tumor agnostic approval of Keytruda (pembrolizumab) based mostly on microsatellite instability does have an effect throughout most cancers; in prostate most cancers, that does apply.
In bladder most cancers, presently, the FGFR3 mutations/fusions that permits us to offer Balversa [erdafitinib]. We’re additionally on the lookout for HER2. With HER2 [positivity], Enhertu [fam-trastuzumab deruxtecan-nxki] is authorized as a pan-tumor approval label. Subsequently, we search for these biomarkers in bladder most cancers.
In renal cell carcinoma, it is slightly unclear in the mean time. The one biomarker that is wanting attention-grabbing is the KIM-1, the circulating proteomic biomarker, which might be an inexpensive biomarker for minimal residual illness. It appears to correlate with the recurrence of tumor post-operation. It additionally appears to correlate with long-term outcomes within the immune checkpoint inhibitor setting, as proven on the ASCO GU Symposium, [with the use of] Yervoy [ipilimumab] and Opdivo [nivolumab]. [Therefore], I believe that biomarkers are rising.
So as to add, I’ll say the minimal residual illness informs circulating tumor DNA [ctDNA] to pick sufferers for adjuvant Opdivo. [On that note], immune checkpoint inhibition is getting used locally, nonetheless, potential validation continues to be ongoing. For instance, the IMvigor011 trial used ctDNA information to information adjuvant remedy, in addition to [guide] remedy on the time of remodeling from ctDNA-negative to ctDNA-positive… Hopefully extra information will come out from the IMvigor011 trial to additional information [this treatment].
There’s a trial ongoing that permits sufferers to be de-intensified or intensified when it comes to adjuvant remedy for high-risk muscle-invasive bladder most cancers based mostly on ctDNA-positive or -negative [status]. General, I believe that each one of those research, after they mature, will convey precision drugs based mostly on tumor alterations in addition to MRD info to information remedy.
Transcript has been edited for readability and conciseness.
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