Dr. Grivas on Unmet Needs in Advanced Urothelial Cancer

Petros Grivas, MD, PhD, director, University of Washington Medicine’s Genitourinary Cancers Program, associate professor, oncology, University of Washington, Seattle Cancer Care Alliance, discusses unmet needs in the treatment of patients with advanced urothelial cancer.

Right now, this setting simply needs more effective therapies, Grivas says, as only chemotherapy and immunotherapy are FDA-approved for the treatment of these patients, to date. There was excitement over early data presented at the 2019 Genitourinary Cancers Symposium, which looked at antibody—drug conjugates like sacituzumab govitecan and FGFR inhibitors like erdafitinib, the latter having received a breakthrough designation by the FDA in March 2018. There are other FGFR-targeted therapies on the rise, he adds.

Investigators need to better biomarker-based patient selection so that they can choose the right drug for the right patient at the right time. This is the whole idea of precision medicine that has generated excitement across disease types. Grivas and colleagues wrote a review article that will be published soon on the premise of precision oncology in advanced urothelial cancer. The article explores the role of PARP inhibitors, FGFR inhibitors, and HER2 inhibitors. Data for some of these agents will be read out at upcoming meetings.

He adds that more work needs to be done in earlier disease settings beyond chemotherapy and immunotherapy. Advances made in combination therapies, biomarker-driven treatment, and early-stage disease will move the needle forward in this space.