ASCO: You’re listening to a podcast from Cancer.Net. This cancer information website is produced by the American Society of Clinical Oncology, known as ASCO, the world’s leading professional organization for doctors who care for people with cancer. The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Cancer research discussed in this podcast is ongoing, so the data described here may change as research progresses. In this podcast, Dr. Neeraj Agarwal discusses new research in kidney, prostate, and bladder cancer presented at the European Society for Medical Oncology Virtual Congress 2020. This meeting was held virtually September 19-21. Dr. Agarwal directs the Genitourinary Oncology Program at the Huntsman Cancer Institute at the University of Utah. He is also a Specialty Editor for Cancer.Net. View Dr. Agarwal’s disclosures at Cancer.Net. ASCO would like to thank Dr. Agarwal for discussing this topic. Dr. Agarwal: Hi, my name is Dr. Neeraj Agarwal. I'm a professor of medicine and the director of genitourinary oncology program at the Huntsman Cancer Institute, Salt Lake City, University of Utah. Today, I'm going to talk about 3 major clinical trials which were presented during the 2020 annual meeting of European Society for Medical Oncology. All these 3 trials are practice-changing trials. And they have huge impact on how we treat patients with bladder cancer, prostate cancer, and advanced kidney cancer. Before I proceed further, I want to disclose that I have consulted and received honorarium to the sponsors of all these 3 trials, which include Exelixis, Galentic, AstraZeneca, Pfizer, and EMD Serono. I was also involved in the conduct of the PROfound clinical trial, the trial in prostate cancer which I am going to discuss about, as a steering committee member. Let's start with the trial in advanced kidney cancer. So this trial was a large phase III trial. It was named as 9ER trial and used a novel combination of cabozantinib plus nivolumab versus sunitinib. Hundreds of patients were randomized to treatment with cabozantinib plus nivolumab versus sunitinib. What we saw was really remarkable. The progression-free survival, which is defined as how long these drugs were able to control the disease from progressing, was remarkably improved with the combination of cabozantinib plus nivolumab versus or over sunitinib. In fact, the progression-free survival was double with the novel combination of cabozantinib with nivolumab versus sunitinib. So if you look at the absolute months, how long the disease was controlled or was contained from progressing, it was 16.6 months with the novel therapy with cabozantinib and nivolumab versus 8 months with sunitinib. In fact, if you look at the progression-free survival estimate as assessed by the treating clinicians who were treating these patients, it was even higher at 19 month versus 9 month. Overall survival was also improved. We do not have data in absolute months in overall survival, but if you look at the hazard ratios, basically that means that there was a 40% reduction in risk of death on treatment with cabozantinib and nivolumab. Even response rates were twice as high with cabozantinib and nivolumab. The most important aspect I would like to highlight of this trial was the quality of life as reported by the patients. The health-related quality of life in patients who received cabozantinib with nivolumab was consistently better throughout the duration of trial treatment over those patients who received sunitinib. And this speaks of the overall tolerability and safety of the agent. To summarize, the combination of cabozantinib and nivolumab is one of t