Dr. Andrea Apolo
speaker
97 appearances
1 recordings
1 series
first heard Oct 2024
last heard Oct 2024
Dr. Andrea Apolo’s voice in public audio — every appearance, attributed to the second.
Trend
recordings per month · last 12 monthsNo recordings in the last 12 months.Older appearances are listed below; set an alert to hear about the next one.
Appearances
Yeah, and I'm glad that it was randomized because, you know, someone can argue, well, they received a systemic treatment with a checkpoint. But they did have a monotherapy checkpoint arm, and the pathologic response rate was much lower. That's right. Sorry, I could have said that, but it was 23%, so half. So it's nice to see that putting the TAR200 in the bladder intensified that.
the treatment effect with almost doubling of the pathologic complete response rate. So I think I'm very excited about this data. And I think that it could be something we could potentially use in the future, along with all these systemic therapies that we are now developing in the perioperative setting.
Yeah, and I don't understand part of the trial. I was very excited by the results. I think that it's great that there was such a great 12-month complete response rate. I think this is the best one that we have seen.
But I don't understand why the combination didn't do as well as them or the monotherapy was the one that did the best, right? So that I wasn't sure if there was some antagonism or it was just the patients. These are really small numbers, right? I mean, the combination- I think it was like 50 patients versus 85 patients in the combination arm. So these are small numbers.
But, you know, why is it that the monotherapy did so well in terms of the CR rate? I think it's the endpoint that is being measured. You know, if you're measuring a local endpoint. and you're giving a local therapy, the local therapy is going to shine. But why didn't it shine when it was in combination with the checkpoint?
So I don't know if this is just a little bit of noise from the... I think they were very similar in terms of the 12-month CR rate, but I would have thought that it would have been a little bit better with the combination, and it wasn't. The TAR-200 did just as well as monotherapy in terms of the 12-month CR.
So I'm excited about the antibody drug conjugates in combination with checkpoint inhibitor trials. There's three large trials, and this is, of course, because of the amazing 302 data where we saw doubling of the overall survival in patients in the first-line treatment with metastatic bladder cancer.
And there are several trials that are ongoing right now asking that question in the perioperative setting. And similar to what we saw with the cisplatinum plus checkpoint inhibitor trials, they have a neoadjuvant component and an adjuvant component.
So there's the EV304 study for patients that are cisplatinum eligible where they get EV plus PEMBRO and in the neoadjuvant setting, and then they get it in the adjuvant setting, and then there's the control arm study. that just get neoadjuvant cisplatinum-based chemotherapy and nothing in the adjuvant setting. And then we saw a little bit of data from the Volga study at ESMO.
And this was basically the safety run-in with the triplet EV, DERVA, TREMI in the neoadjuvant setting and then in the adjuvant setting. And they were really looking at clearance of ctDNA. And they found that There's a pathologic complete response rate, and there's also downstaging of the tumor, and there's clearance of the ctDNA. So that may be a good biomarker for efficacy. So more to come.
It was really small. It was like 17 patients in the lead-in. But I think exciting in that, you know, the trial is... going forward. And there's multiple arms to that study. So they only showed the safety of the triplet. There's also a doublet with EV plus Dervalumab and then Dervalumab as adjuvant. And then the weird part is that the control arm is no therapy.
But in all fairness, that's kind of what we did with our patients if they were not cisplatinum eligible. We didn't give them cisplatinum-based therapy because they can't receive it. We don't give them carboplatinum. And then we observed them in the adjuvant setting. So that's the control arm for the Volga study.
And then there's another trial also for patients that are cisplatinum ineligible, the EV303 study. And that one is EV plus PEMBRO again in the neoadjuvant setting and then in the adjuvant setting. And this is the great thing about EV plus PEMBRO is that it doesn't matter whether you are cisplatinum eligible or not. You can get this treatment. So they're, again, sandwiching it.
And they also have a monotherapy PEMBRO arm. And then they have a no therapy arm where they get no therapy in the neoadjuvant and no therapy in the adjuvant setting. So I'm excited about these trials.
I think that, you know, if we see this fantastic activity that we saw in the metastatic setting, now in the perioperative setting with no concerns about surgical outcomes, then I think this will be the new standard of care. So those are the trials that I am really waiting to hear about. the results of over the next few years.
This was great. You asked such great questions that are really important and that we're dealing with on a daily basis. And how do we now take this data that we just saw at ESMO and apply it to our clinic? And I think we're still figuring that out. So it's fun to have these conversations. And I think the conversations will be evolving. So more to come.
Social media and PR by Chi Ding. Administrative support provided by Jamila Kinabru.
Showing 81–97 of 97 · page 5 of 5
← Previous