Satellite Symposium: Immunotherapy in Metastatic Urothelial Carcinoma

The role of chemotherapy in metastatic urothelial carcinoma (mUC); understanding cisplatin- and platinum-eligibility

4th Oct 2022, 16:00 – 17:30 CEST

Urothelial carcinoma (UC) is the predominant type of bladder cancer, accounting for over 90% of all bladder cancers. Eleven percent (11%) of UC cases are metastatic (mUC) at diagnosis, and 50% of UC cases will eventually progress to mUC. Currently, a cisplatin-based combination chemotherapy regimen is the standard of care for the first-line treatment for mUC patients, however some patients are either too sick, frail, or elderly and cannot be given cisplatin due to toxicity concerns and potentially making them more ill – these patients are termed cisplatin-ineligible. For cisplatin-ineligible patients, carboplatin-based regimens are offered as first-line treatment. For those that cannot receive cisplatin or carboplatin, there are non-platinum chemotherapy first-line regimens that may be administered. Additionally, the FDA has approved immunotherapy agents, atezolizumab and pembrolizumab, targeting PD-1/PD-L1 for mUC patients, which may also be used as a first-line treatment option for mUC patients. Initially, these agents were to be used for mUC patients that were not eligible for cisplatin-based chemotherapy, however, in 2018 the FDA changed the criteria for which mUC patients these immunotherapy agents could be administered to included patients who were not eligible for any platinum-based chemotherapy. Although cisplatin-ineligibility has been defined for a long time, these changes gave rise to the need for a uniform decision on platinum-ineligibility, which is a very new term. There are knowledge gaps in the understanding of the role of chemotherapy in mUC, including the role of non-platinum-based chemotherapy as well as the understanding of cisplatin and platinum eligibility in mUC patients. The proposed 90-minute interactive, virtual satellite symposium will be hosted at the 9th EUSTM Annual Clinical & Translational Conference (EUSTM-2022) Congress on Immunotherapies – From Biology to Patient Care. The objective of this event is to increase the knowledge and understanding that HCPs have about the role that chemotherapy plays in treating mUC and the criteria to define cisplatin and platinum eligibility. Effectiveness of the program will be measured through multiple evaluation methods.

Learning Objectives

After completing the independent medical educational activity, learners will be able to:

1. Understand the general role of chemotherapy, with attention to non-platinum-based chemotherapy in mUC.
2. Understand and describe the criteria for cisplatin eligibility.

3. Understand and explain the criteria for platinum eligibility.

4. Compare and contrast between cisplatin and platinum eligibility.

Expert Talk 1: Defining an ‘unfilt’ patient for Cisplatin-based chemo for the upfront treatment of metastatic urothelial carcinomas

Prof. Matthew Galsky
*Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, NY, USA

Expert Talk 2: Understanding the criteria for platinum eligibility in mUC

Dr Shilpa Gupta
*Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio, USA

Expert Talk 3: First line treatment for mUC in the context of the available data and both patient (platinum, cisplatin eligibility) & biomarkers

Prof. Guru Sonpavde
*Dana Farber Cancer Institute, Harvard Medical School, Boston, USA

Expert Panel Discussion and Questions & Answers

Panelists: Shilpa Gupta, Matthew Galsky and Guru Sonpavde

Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio, USA. Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, NY, USA and *Dana Farber Cancer Institute, Harvard Medical School, Boston, USA.

Certificate of attendance: The certificates will be given to those attendees who will complete pre & post symposium evaluation quiz.

Conflict of interests: No known conflict of interests

Acknowledgment: This symposium is supported by educational grants from Pfizer, Merck and Astellas pharma.