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ASCO GU 2023 Highlights With Dr. Julie Gralow

Op-Med is a collection of original articles contributed by Doximity members.

The 2023 ASCO Genitourinary Cancers Symposium brought together oncology professionals from around the globe for presentations and discussions surrounding the latest innovative findings in genitourinary cancer treatment, research, and care. The theme of the Symposium, “Today’s Science, Tomorrow’s Treatment,” reflects the fast pace and promise of therapeutic advances in GU oncology, including practice-changing studies in prostate, kidney, and bladder cancer. I was thrilled to join more than 5,600 colleagues from 79 countries to hear the latest research in GU cancers. 

Research presented at the Symposium spanned the full spectrum of cancer care – from risk reduction to advanced cancer treatment. Several pivotal clinical trials provided follow-up or updated data, including JAVELIN Bladder-100, COSMIC-021, CheckMate-247, and CheckMate 9ER, among others. 

One of the most buzzed about presentations was an observational study of more than 2,000 patients with prostate cancer that examined the associations between plant-based diets and risk of prostate cancer progression and recurrence. Patients who reported eating a diet highest in plants had a 52% lower risk of progression and a 53% lower risk of recurrence compared to participants who reported the lowest amounts of plants in their diets. These findings may directly inform clinical care, such as providing diet recommendations for managing health, and potentially offer other positive health benefits for preventing numerous chronic diseases. Vivian Liu, Clinical Research Coordinator, Osher Center for Integrative Health, University of California, San Francisco, and lead study author of the study said, “We hope these results guide people at risk to make better, more healthful choices across their entire diet. We’ve known that diets that include vegetables, fruits, legumes, and whole grains are associated with numerous health benefits, including a reduction in diabetes, cardiovascular disease, and overall mortality. We can now add benefits in reducing prostate cancer progression to that list.”

We’re also seeing progress in the treatment of advanced prostate cancer. The TALAPRO-2 phase III clinical trial found that a poly(ADP-ribose) polymerase inhibitor (talazoparib) combined with an androgen receptor inhibitor (enzalutamide) had significantly better progression-free survival versus the current standard of care (enzalutamide alone) for people with metastatic, castration-resistant prostate cancer, regardless of homologous recombination repair pathway status. Lead study author Neeraj Agarwal, MD, FASCO, Professor of Medicine and Director of the Genitourinary Oncology Program at the Huntsman Cancer Institute, University of Utah provided additional context about the importance of this research, “This is important because advanced prostate cancer can be associated with pain, fractures, suffering, and death. The current standard-of-care treatments were approved almost a decade ago leaving a huge unmet need for novel drugs in this setting.”

With health equity continuing to be a topic at the forefront across medical specialties, new research identified disparities when it comes to cancer clinical trials. Presented by Irbaz Bin Riaz, MD, PhD, of the Dana-Farber Cancer Institute, research revealed that Black and Hispanic men with prostate cancer continue to be underrepresented in clinical trials—specifically those funded by industry—with enrollment rates far lower than expected based on the actual incidence of prostate cancer in these populations. Moreover, the numbers show that Black men have continually been underrepresented in industry-sponsored prostate cancer clinical trials over the past three decades with little change in enrollment rates over time. Underrepresentation in clinical trials may impede access to treatments for some groups of patients, while also leaving disparities unaddressed.  

One of the biggest highlights for me was hearing former National Cancer Institute Director Norman E. Sharpless, MD, of the University of North Carolina School of Medicine, who discussed the federal Cancer Moonshot program and how to reduce cancer mortality in a plenary presentation entitled “Ending Cancer as We Know: Predicting Future Cancer Progress.” Dr. Sharpless highlighted some of the progress made over the past 20 years in GU cancers, but tempered this news with the stark reality that many patients are still unable to access these newer treatments due to a multitude of complex factors such as rising drug costs and social determinants of health. He encouraged the GU cancers community to “step on the gas,” in addressing systemic issues that impact patient outcomes. 

Thanks to our multidisciplinary team of experts who put the science into context, attendees were provided with a truly holistic view of the latest innovations in the GU field. Most importantly, the Symposium demonstrated how our community continues to work hard to improve the lives of people living with cancer across the globe. I was excited to see the Symposium theme, “Today’s Science, Tomorrow’s Treatment,” come to life in the research presentations, small group discussions, and thoughtful question and answer sessions.

Dr. Gralow has no conflicts of interest to report.

Image by DrAfter123 / Getty

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