#TumorBoardTuesday Matt Galsky Amanda Nizam, MD Brian Rini, MD Petros Grivas Nick James Toni Choueiri, MD Rana McKay Rafee Talukder Shilpa Gupta Adam B. Weiner, MD Adam Kibel aurelius omlin Arnab Basu Arvin K. George, MD Arun Azad 𝙳𝚊𝚟𝚒𝚍 𝙲𝚊𝚗𝚎𝚜 Ciara Conduit Dana-Farber Lank Center for Genitourinary Oncology Dan George Ali Khaki Mike Glover Daniel Petrylak D'Ann George Deborah Mukherji DrTylerStewart Emmanuel Antonarakis EAU Edu Platform UROONCO Elena Castro Edward Schaeffer Eric Jonasch Tamas Fazekas MD Jean Hoffman-Censits Brian Shuch, MD Miguel Sotelo Santhosh Ambika Russell Pachynski Scot Niglio MD Alfonso Gómez de Liaño Sam S. Chang MD, MBA Joseph Vento Tom Powles drfrankiejs Katy Beckermann Albert Jang, MD 13/22 #TumorBoardTuesday

👨🏽‍🏫Mini Tweetorial 8👨🏽‍🏫

Also at EMSO 2023:
✨CM901✨
📍Phase 3
📍Gem/Cis + Nivo vs Gem/Cis
📍1L for unresectable/mUC Cis-eligible pts
📍Could have received neoadj/adj chemo if >12m prior

Matt Galsky Michiel van der Heijden Guru P. Sonpavde, MD Tom Powles Andrea Necchi

#TumorBoardTuesday Matt Galsky Amanda Nizam, MD Brian Rini, MD Petros Grivas Nick James Toni Choueiri, MD Rana McKay Rafee Talukder Shilpa Gupta Adam B. Weiner, MD Adam Kibel aurelius omlin Arnab Basu Arvin K. George, MD Arun Azad 𝙳𝚊𝚟𝚒𝚍 𝙲𝚊𝚗𝚎𝚜 Ciara Conduit Dana-Farber Lank Center for Genitourinary Oncology Dan George Ali Khaki Mike Glover Daniel Petrylak D'Ann George Deborah Mukherji DrTylerStewart Emmanuel Antonarakis EAU Edu Platform UROONCO Elena Castro Edward Schaeffer Eric Jonasch Tamas Fazekas MD Jean Hoffman-Censits Brian Shuch, MD Miguel Sotelo Santhosh Ambika Russell Pachynski Scot Niglio MD Alfonso Gómez de Liaño Sam S. Chang MD, MBA Joseph Vento Tom Powles drfrankiejs Katy Beckermann Albert Jang, MD Michiel van der Heijden Guru P. Sonpavde, MD Andrea Necchi 14/22 #TumorBoardTuesday

👨🏽‍🏫Mini Tweetorial 9👨🏽‍🏫

✨CM901✨
📍⬆️ OS - HR 0.78 (median 21.7mo vs 18.9mo)
📍⬆️ PFS - HR 0.72 (median 7.9 mo vs 7.6 mo)
📍⬆️ ORR - 57.6% vs 43.1% (CR 21.7% vs 11.8%)
📍⬆️ mDoR - 37.1 mo vs 13.2 mo
📍 G3 AE 61.8% vs 51.7%

#TumorBoardTuesday Matt Galsky Amanda Nizam, MD Brian Rini, MD Petros Grivas Nick James Toni Choueiri, MD Rana McKay Rafee Talukder Shilpa Gupta Adam B. Weiner, MD Adam Kibel aurelius omlin Arnab Basu Arvin K. George, MD Arun Azad 𝙳𝚊𝚟𝚒𝚍 𝙲𝚊𝚗𝚎𝚜 Ciara Conduit Dana-Farber Lank Center for Genitourinary Oncology Dan George Ali Khaki Mike Glover Daniel Petrylak D'Ann George Deborah Mukherji DrTylerStewart Emmanuel Antonarakis EAU Edu Platform UROONCO Elena Castro Edward Schaeffer Eric Jonasch Tamas Fazekas MD Jean Hoffman-Censits Brian Shuch, MD Miguel Sotelo Santhosh Ambika Russell Pachynski Scot Niglio MD Alfonso Gómez de Liaño Sam S. Chang MD, MBA Joseph Vento Tom Powles drfrankiejs Katy Beckermann Albert Jang, MD Michiel van der Heijden Guru P. Sonpavde, MD Andrea Necchi 15/22 #TumorBoardTuesday

Back to our case🔎

➡️Pt received EV + pembro
🩻Restaging scans with CR
😷Developed a rash (must be cautious for SJS/TEN)
👉EV dose reduced and eventually stopped
👉Pembro continued

#TumorBoardTuesday Matt Galsky Amanda Nizam, MD Brian Rini, MD Petros Grivas Nick James Toni Choueiri, MD Rana McKay Rafee Talukder Shilpa Gupta Adam B. Weiner, MD Adam Kibel aurelius omlin Arnab Basu Arvin K. George, MD Arun Azad 𝙳𝚊𝚟𝚒𝚍 𝙲𝚊𝚗𝚎𝚜 Ciara Conduit Dana-Farber Lank Center for Genitourinary Oncology Dan George Ali Khaki Mike Glover Daniel Petrylak D'Ann George Deborah Mukherji DrTylerStewart Emmanuel Antonarakis EAU Edu Platform UROONCO Elena Castro Edward Schaeffer Eric Jonasch Tamas Fazekas MD Jean Hoffman-Censits Brian Shuch, MD Miguel Sotelo Santhosh Ambika Russell Pachynski Scot Niglio MD Alfonso Gómez de Liaño Sam S. Chang MD, MBA Joseph Vento Tom Powles drfrankiejs Katy Beckermann Albert Jang, MD Michiel van der Heijden Guru P. Sonpavde, MD Andrea Necchi 16/22 #TumorBoardTuesday

🩻1 year later -> scans show new lesions c/w POD
🤔What do you do now❓

#TumorBoardTuesday Matt Galsky Amanda Nizam, MD Brian Rini, MD Petros Grivas Nick James Toni Choueiri, MD Rana McKay Rafee Talukder Shilpa Gupta Adam B. Weiner, MD Adam Kibel aurelius omlin Arnab Basu Arvin K. George, MD Arun Azad 𝙳𝚊𝚟𝚒𝚍 𝙲𝚊𝚗𝚎𝚜 Ciara Conduit Dana-Farber Lank Center for Genitourinary Oncology Dan George Ali Khaki Mike Glover Daniel Petrylak D'Ann George Deborah Mukherji DrTylerStewart Emmanuel Antonarakis EAU Edu Platform UROONCO Elena Castro Edward Schaeffer Eric Jonasch Tamas Fazekas MD Jean Hoffman-Censits Brian Shuch, MD Miguel Sotelo Santhosh Ambika Russell Pachynski Scot Niglio MD Alfonso Gómez de Liaño Sam S. Chang MD, MBA Joseph Vento Tom Powles drfrankiejs Katy Beckermann Albert Jang, MD Michiel van der Heijden Guru P. Sonpavde, MD Andrea Necchi 17/22 #TumorBoardTuesday

✨Remaining Questions✨
🤔What should be 2L after EV + pembro❓
➡️Chemo (gem+cis/carbo or ddMVAC)❓
👉In EV-302, most Pts needing 2⃣L Tx after EV + pembro received platinum-based chemo

#TumorBoardTuesday Matt Galsky Amanda Nizam, MD Brian Rini, MD Petros Grivas Nick James Toni Choueiri, MD Rana McKay Rafee Talukder Shilpa Gupta Adam B. Weiner, MD Adam Kibel aurelius omlin Arnab Basu Arvin K. George, MD Arun Azad 𝙳𝚊𝚟𝚒𝚍 𝙲𝚊𝚗𝚎𝚜 Ciara Conduit Dana-Farber Lank Center for Genitourinary Oncology Dan George Ali Khaki Mike Glover Daniel Petrylak D'Ann George Deborah Mukherji DrTylerStewart Emmanuel Antonarakis EAU Edu Platform UROONCO Elena Castro Edward Schaeffer Eric Jonasch Tamas Fazekas MD Jean Hoffman-Censits Brian Shuch, MD Miguel Sotelo Santhosh Ambika Russell Pachynski Scot Niglio MD Alfonso Gómez de Liaño Sam S. Chang MD, MBA Joseph Vento Tom Powles drfrankiejs Katy Beckermann Albert Jang, MD Michiel van der Heijden Guru P. Sonpavde, MD Andrea Necchi 18/22 #TumorBoardTuesday

✨Remaining Questions✨
➡️Potential role for 2L gem/cis + nivo despite progression on pembro unknown
🤔What if pt had progressed off pembro❓

#TumorBoardTuesday Matt Galsky Amanda Nizam, MD Brian Rini, MD Petros Grivas Nick James Toni Choueiri, MD Rana McKay Rafee Talukder Shilpa Gupta Adam B. Weiner, MD Adam Kibel aurelius omlin Arnab Basu Arvin K. George, MD Arun Azad 𝙳𝚊𝚟𝚒𝚍 𝙲𝚊𝚗𝚎𝚜 Ciara Conduit Dana-Farber Lank Center for Genitourinary Oncology Dan George Ali Khaki Mike Glover Daniel Petrylak D'Ann George Deborah Mukherji DrTylerStewart Emmanuel Antonarakis EAU Edu Platform UROONCO Elena Castro Edward Schaeffer Eric Jonasch Tamas Fazekas MD Jean Hoffman-Censits Brian Shuch, MD Miguel Sotelo Santhosh Ambika Russell Pachynski Scot Niglio MD Alfonso Gómez de Liaño Sam S. Chang MD, MBA Joseph Vento Tom Powles drfrankiejs Katy Beckermann Albert Jang, MD Michiel van der Heijden Guru P. Sonpavde, MD Andrea Necchi 19/22 #TumorBoardTuesday

➡️Other remaining lines of tx:
👉Sacituzumab govitecan, erdafitinib (if +FGFR 2/3), clinical trial

🤔Ok to give ADC with same payload in later line❓ 👉Disitamab vedotin (MMAE) + IO💡prelim results promising for HER2+ UC

#TumorBoardTuesday Matt Galsky Amanda Nizam, MD Brian Rini, MD Petros Grivas Nick James Toni Choueiri, MD Rana McKay Rafee Talukder Shilpa Gupta Adam B. Weiner, MD Adam Kibel aurelius omlin Arnab Basu Arvin K. George, MD Arun Azad 𝙳𝚊𝚟𝚒𝚍 𝙲𝚊𝚗𝚎𝚜 Ciara Conduit Dana-Farber Lank Center for Genitourinary Oncology Dan George Ali Khaki Mike Glover Daniel Petrylak D'Ann George Deborah Mukherji DrTylerStewart Emmanuel Antonarakis EAU Edu Platform UROONCO Elena Castro Edward Schaeffer Eric Jonasch Tamas Fazekas MD Jean Hoffman-Censits Brian Shuch, MD Miguel Sotelo Santhosh Ambika Russell Pachynski Scot Niglio MD Alfonso Gómez de Liaño Sam S. Chang MD, MBA Joseph Vento Tom Powles drfrankiejs Katy Beckermann Albert Jang, MD Michiel van der Heijden Guru P. Sonpavde, MD Andrea Necchi 20/22 #TumorBoardTuesday

✨Remaining Q✨

🤔Role for EV + IO in earlier stage Dz❓
➡️EV-303/KN-905: Ph3 peri-op EV+Pembro in Cis-ineligible MIBC
➡️EV-304/KN-B15: Ph3 peri-op EV+Pembro in Cis-eligible MIBC
➡️VOLGA: Ph3 peri-op EV+durvalumab +/- tremelimumab in cis-ineligible MIBC

#TumorBoardTuesday Matt Galsky Amanda Nizam, MD Brian Rini, MD Petros Grivas Nick James Toni Choueiri, MD Rana McKay Rafee Talukder Shilpa Gupta Adam B. Weiner, MD Adam Kibel aurelius omlin Arnab Basu Arvin K. George, MD Arun Azad 𝙳𝚊𝚟𝚒𝚍 𝙲𝚊𝚗𝚎𝚜 Ciara Conduit Dana-Farber Lank Center for Genitourinary Oncology Dan George Ali Khaki Mike Glover Daniel Petrylak D'Ann George Deborah Mukherji DrTylerStewart Emmanuel Antonarakis EAU Edu Platform UROONCO Elena Castro Edward Schaeffer Eric Jonasch Tamas Fazekas MD Jean Hoffman-Censits Brian Shuch, MD Miguel Sotelo Santhosh Ambika Russell Pachynski Scot Niglio MD Alfonso Gómez de Liaño Sam S. Chang MD, MBA Joseph Vento Tom Powles drfrankiejs Katy Beckermann Albert Jang, MD Michiel van der Heijden Guru P. Sonpavde, MD Andrea Necchi 21/22 #TumorBoardTuesday

✨Remaining Questions✨

🤔Chemo + dual IO in mUC❓
➡️NILE: Ph3 durva + tremelimumab + chemo

#TumorBoardTuesday Matt Galsky Amanda Nizam, MD Brian Rini, MD Petros Grivas Nick James Toni Choueiri, MD Rana McKay Rafee Talukder Shilpa Gupta Adam B. Weiner, MD Adam Kibel aurelius omlin Arnab Basu Arvin K. George, MD Arun Azad 𝙳𝚊𝚟𝚒𝚍 𝙲𝚊𝚗𝚎𝚜 Ciara Conduit Dana-Farber Lank Center for Genitourinary Oncology Dan George Ali Khaki Mike Glover Daniel Petrylak D'Ann George Deborah Mukherji DrTylerStewart Emmanuel Antonarakis EAU Edu Platform UROONCO Elena Castro Edward Schaeffer Eric Jonasch Tamas Fazekas MD Jean Hoffman-Censits Brian Shuch, MD Miguel Sotelo Santhosh Ambika Russell Pachynski Scot Niglio MD Alfonso Gómez de Liaño Sam S. Chang MD, MBA Joseph Vento Tom Powles drfrankiejs Katy Beckermann Albert Jang, MD Michiel van der Heijden Guru P. Sonpavde, MD Andrea Necchi 22/22 #TumorBoardTuesday

Take home points:

✅ New SOC for 1L la/mUC – EV + Pembro with 53% ⬇️ risk of death, nearly doubled mOS
✅ Many questions unanswered to optimize EV + IO and subsequent lines of tx
✅ Ongoing trials looking at peri-op EV + IO for MIBC

#TumorBoardTuesday Matt Galsky Amanda Nizam, MD Brian Rini, MD Petros Grivas Nick James Toni Choueiri, MD Rana McKay Rafee Talukder Shilpa Gupta Adam B. Weiner, MD Adam Kibel aurelius omlin Arnab Basu Arvin K. George, MD Arun Azad 𝙳𝚊𝚟𝚒𝚍 𝙲𝚊𝚗𝚎𝚜 Ciara Conduit Dana-Farber Lank Center for Genitourinary Oncology Dan George Ali Khaki Mike Glover Daniel Petrylak D'Ann George Deborah Mukherji DrTylerStewart Emmanuel Antonarakis EAU Edu Platform UROONCO Elena Castro Edward Schaeffer Eric Jonasch Tamas Fazekas MD Jean Hoffman-Censits Brian Shuch, MD Miguel Sotelo Santhosh Ambika Russell Pachynski Scot Niglio MD Alfonso Gómez de Liaño Sam S. Chang MD, MBA Joseph Vento Tom Powles drfrankiejs Katy Beckermann Albert Jang, MD Michiel van der Heijden Guru P. Sonpavde, MD Andrea Necchi #PostTest Q1️⃣ #TumorBoardTuesday
👉🏽 #CME Eval 🔗 integrityce.com/TBTeval23
👉🏽ALL CME🔗 integrityce.com/TBT2023

🤔What 1L Tx would you give to a 68yo♂️w/ mUC, PS 1, & new SOB after 1y after gem/cis & cystectomy❓