Reflecting on research in genitourinary cancers

Dana Walker, MD, MSCE, our vice president and Global Program Lead, Genitourinary (GU) Cancers, sheds light on the importance of ongoing GU cancer research, the unmet needs for patients with GU tumors and where we go from here to offer hope to even more people impacted by cancer.

Q: What does the treatment landscape currently look like for patients with GU cancers, and how does it differ from other areas?

Dr. Walker: GU cancer research has progressed significantly over the last several years in both the metastatic setting and in earlier stages of disease. Previously, the standard of care for many GU cancer types – including kidney cancer, bladder cancer and prostate cancer – was chemotherapy. However, over the last several years, we’ve seen many new modalities and mechanisms come into play – including immunotherapy, targeted agents, antibody drug conjugates and radioligand therapy in the metastatic setting, as well as some new data on immunotherapies in earlier lines of treatment for both kidney and bladder cancer. This is a really exciting time. Since GU cancers extend over multiple different tumor types, I think we have an opportunity here to explore a wide variety of mechanisms, both alone and in combination.

Q: In your opinion, what are the most exciting advancements or areas of research in this field?

Dr. Walker: Many new mechanisms have been established as standards of care across kidney, bladder and prostate cancers in recent years. Not only is BMS at the forefront with various treatments in these areas, but we’ve also had a great opportunity to collaborate across the global cancer community, including with industry partners and academic research institutions. In my opinion, a lot of the excitement lies in this ability to pursue novel combinations across mechanisms and expand the research to explore novel options.

One area where we’re trying to establish new standards of care is across specific patient populations. For some GU cancers, there aren’t known, specific genomic targets or biomarkers of relevance, which presents a challenge for physicians trying to tailor treatments to each individual patient. So, that’s an area where we can continue to improve to meet the needs of even more patients. Currently, treatments are mostly being used broadly across patient segments. It’s important to continue to collaborate and conduct translational research to establish the best treatments for each segment to improve outcomes for all patients.

Q: What options are being explored in metastatic stages of these diseases? How about in earlier stages?

Dr. Walker: In the metastatic setting, we’re continuing to find new modalities that are relevant across GU malignancies. We’ve come a long way with treatments such as immunotherapies and targeted agents. The most interesting question being asked in research now is: how we can we combine these? Exploring combination approaches can help us find ways to serve patients who are still facing high unmet needs. While the scientific community has significantly increased long-term survival benefits in this field and have achieved longer, durable responses, we still have patients who don’t respond. Combining these proven agents and partnering to find new drugs that may work here is crucial.

The same applies in the earlier stages of disease. We’ve done a lot of great research in the metastatic setting and now we’re evaluating how we can apply those learnings to the earlier stages of the disease and testing whether these mechanisms work there. We’ve already seen tremendous developments, especially in kidney and bladder cancers, over the last several years, specifically with immunotherapy in earlier treatment settings. It’s truly transformative work.

Q: What do upcoming data to be presented at ESMO 2023 mean for patients with GU cancers?

Dr. Walker: I think ESMO is going to be very insightful this year. In addition to sharing our own data in GU cancers, specifically in bladder cancer, we’re excited to see what others have to share, as well. 

At BMS, we’re looking forward to presenting new results in patients with unresectable or metastatic urothelial carcinoma at ESMO, especially in subgroups with high unmet needs.

Q: Where do you think the field of GU cancer research is headed?

Dr. Walker: We’re continuing to refine the way we treat the patients with the highest unmet needs and create a better understanding of those needs. We have been treating patients with GU cancers pretty homogenously and I think we need to continue to improve our knowledge of the tumor biology so that we can get more granular with our treatments and ensure we’re reaching more patients in need. Whether that’s through genomic profiling, biomarkers or examining other correlative data from previous studies to see how we can apply it to new assets or new targets or other groundbreaking data that comes out over the next few months to years, we’re excited to learn more and better understand how we can serve more patients.