Genitourinary Cancer Treatment | Hackensack Meridian Health   

Hackensack University Medical Center Is at the Forefront of Genitourinary Cancer Treatment, Applying Latest Immunotherapy Treatment Combinations

Backed by pioneering research, Hackensack University Medical Center’s John Theurer Cancer Center provides innovative kidney, bladder, and prostate cancer care using the latest immunotherapy treatment combinations.

Urology Immotherapy

Backed by pioneering research, Hackensack University Medical Center’s John Theurer Cancer Center provides innovative kidney, bladder, and prostate cancer care using the latest immunotherapy treatment combinations.

The urologic oncology experts at Hackensack University Medical Center’s John Theurer Cancer Center are at the forefront of genitourinary cancer research and treatment, using and testing the latest immunotherapy medications and protocols to treat kidney, bladder and prostate cancer.

Immunotherapy treatment often is used in combination with other treatments, such as surgery, targeted therapy, chemotherapy or radiation. It can also be used as a second-line therapy if cancer does not respond to or returns after traditional treatment, or if conventional treatments cause intolerable side effects.

“Immunotherapy is usually a tolerable therapy that provides patients with an excellent quality of life,” said Robert Alter, M.D., co-chief of Urologic Oncology at John Theurer Cancer Center.

While immunotherapy does not cause the nausea and hair loss sometimes associated with chemotherapy, it can be toxic and needs to be administered properly following guidelines established by the U.S. Food and Drug Administration (FDA). Patients who receive immunotherapy must be carefully monitored for signs of toxicity,such as an overactive immune response that can lead to inflammation in the body.

Oncologists at John Theurer Cancer Center at Hackensack University Medical Center are now using next-generation sequencing to identify specific tumor markers resulting from gene mutations, enabling them to select immunotherapy and targeted treatments that will deliver the most cancer-fighting benefit.

Newer medications, called immune checkpoint inhibitors, target specific proteins and restore the ability of immune cells to fight cancer. These medications can be used alone or in combination to target specific proteins that make up the tumor. For example, a study called CheckMate 214 showed that 11 percent of patients with stage IV kidney cancer who used nivolumab combined with ipilimumab —two immune checkpoint inhibitor medications —were able to achieve complete remission. Immunotherapy medication pembrolizumab combined with targeted drug axitinib is often used as the first treatment for advanced kidney cancer, and a study showed that 59 percent of patients experienced shrinkage of their tumor. Immunotherapy medications can also be used as a maintenance treatment for kidney cancer, which can prevent cancer from spreading or returning.

Immunotherapy can be an option for patients with bladder cancer who are unable to tolerate chemotherapy, or when chemotherapy is ineffective. Similar to kidney cancer, bladder cancer is treated with immune checkpoint inhibitors that are given via intravenous infusion every 2-3 weeks. The JAVELIN Bladder 100 trial showed a 50-percent improvement in overall survival for patients who received maintenance immunotherapy with the drug avelumab.

“Having the ability to switch treatment mechanisms if one treatment isn’t working gives patients reassurance,” said Dr. Alter. “We are taking science and moving cancer care forward.”

Immunotherapy and targeted therapies are also used to treat prostate cancer, but hormone therapy —also called androgen suppression therapy —is also an option. Hormone therapy reduces the number of male hormones called androgens so they can no longer fuel prostate cancer cells. Hormone therapy can be delivered as an injection administered in the doctor’s office, or as a daily oral medication. Studies have shown that injectable medication results in hormone suppression in 4-6 weeks, while oral medication achieves a similar result in just one week.

“In addition to exploring new, effective treatment options, we are also looking at how we administer medications and the impact that mayhave on a patient’s quality of life,” said Dr. Alter.

Hackensack University Medical Center routinely participates in leading-edge clinical trials, providing genitourinary cancer patients with access to some of the most promising therapies years before they receive FDA approval and become available to the public.

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