Balancing Efficacy and Feasibility in Advanced Bladder Cancer – International Urology Cancer Summit
International Urology Cancer Summit shared a post on LinkedIn:
“Balancing Efficacy and Feasibility in Advanced Bladder Cancer: Insights from the SOGUG-AUREA Trial
The SOGUG-AUREA trial offers important insights for treating cisplatin-ineligible metastatic urothelial carcinoma (mUC). Combining atezolizumab with split-dose cisplatin/gemcitabine, the study achieved:
- 48.5% response rate (including 10.6% complete responses)
- Median OS of 12.9 months
- Manageable toxicity (grade ≥3 AEs: 66.7%, primarily hematologic)
While EV + pembrolizumab (EV-302) remains the gold standard (OS: 31.5 months), this regimen may fill critical gaps.
Case in Point:
A 72-year-old man with mUC (lymph node/lung metastases, CrCl 45 mL/min, ECOG 1) received this combination:
- Tolerated 6 cycles with dose delays for neutropenia
- Achieved partial response lasting 14 months
- Avoided EV-related neuropathy (pre-existing grade 2 neuropathy)
When to Consider This Approach:
- Limited access to EV (geographic or financial barriers)
- ECOG 2 or frail patients ineligible for EV trials
- Preference for time-limited chemo over continuous therapy
Kudos to Guillermo De Velasco Oria de Rueda, Javier Puente, Álvaro Pinto, David Sanchez-Lorente and the SOGUG team for advancing pragmatic options in this complex landscape.”
Title: Split-Dose Cisplatin Plus Atezolizumab for Patients With Urothelial Carcinoma Who Are Considered Ineligible for Full Doses of Cisplatin (SOGUG-AUREA)
Authors: Guillermo de Velasco, Iciar García-Carbonero, Emilio Esteban-González, Alvaro Pinto, David Lorente, Alfonso Gómez de Liaño, Esther Martínez Ortega, Laura Jimenez Colomo, Javier Puente, Iria González, Ovidio Fernandez Calvo, Georgia Anguera, Irene Otero, Carlos Alvarez Fernandez, Ana Pertejo Fernández, Alfredo Sánchez Hernández, Elisenda Llabrés, Natalia Vidal, Mireia Llobet, Enrique Gonzalez-Billalabeitia
Read The Full Article at Journal of Clinical Oncology.
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