Abstract
What is this summary about? People with locally advanced or metastatic cancer of the bladder and upper urinary tract (also called urothelial cancer) are often treated with a type of platinum-based chemotherapy called cisplatin and/or immunotherapy. Not all patients can be treated with cisplatin. Cancer can also get worse after prior therapies including immunotherapy. Sacituzumab govitecan (brand name: TRODELVY®) is a type of cancer medicine called an antibody-drug conjugate. Antibody-drug conjugates are made of an antibody to find the cancer cells in your body and a drug to kill the cancer cells. The TROPHY-U-01 study looked at how well this treatment works in people with locally advanced or metastatic urothelial cancer who have already been treated with 1 or 2 other types of cancer treatments. The study included more than 1 group (‘cohort’) of participants. This paper reports results in participants who could not take cisplatin and whose cancer got worse after immunotherapy (Cohort 2). All participants got sacituzumab govitecan. What were the results? There were 38 participants in Cohort 2. Before treatment, most participants had cancer that had spread to their internal organs. After sacituzumab govitecan treatment, the tumors in 12 of 38 participants (32%) shrank by a degree that was substantial enough for doctors to consider a ‘response’ to treatment. This response started at a median of 1.4 months of treatment and lasted for a median of 5.6 months. In 13 of 38 participants (34%), the cancer remained stable for some time. In 16 of 38 participants (42%), the cancer was controlled (not worsened) for at least 6 months. All participants had adverse events regardless of the cause. The most common severe adverse events were low levels of certain blood cells, tiredness, and diarrhea. What do the results of the study mean? The study showed that sacituzumab govitecan treatment worked well on its own, with response noted in about one-third of participants with locally advanced or metastatic urothelial cancer who could not take cisplatin and whose cancer got worse after immunotherapy alone.