Tom Powles (@tompowles1) / X

Tom Powles

2,476 posts

Tom Powles

@tompowles1

Interested in Urology Cancers, biomarkers and drug development.

Joined December 2019

Tom Powles
@tompowles1
Oct 22, 2023
Enfortumab vedotin & Pembrolizumab improving PFS & OS by 55% & 53% respectively compared to platinum based chemo in 1st line UC (+avelumab in 30%). Chemo has not been beaten before (despite multiple efforts). RR and CR of 68% & 29% is hard to beat. DOR not reached (1/3)#ESMO2023
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Tom Powles
@tompowles1
Dec 15, 2023
A big day for bladder ca patients @US_FDA. Massive team effort. Platinum based chemo superseded at last. EV/pembro will transform the lives of many pts with this difficult disease. Still lots to do but it’s a pretty good day and worth pausing for a moment.
FDA approves enfortumab vedotin-ejfv with pembrolizumab for locally ad
From fda.gov
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Tom Powles
@tompowles1
Mar 6, 2024
Enfortumab + Pembro outperforms platinum chemotherapy in advanced UC with a doubling of PFS and a halving of the risk of death @NEJM. G3/4 AEs of 56% for EVP vs 70% for chemo & CR=29%. Editorial by @GNiegisch ‘EVP is the new standard against which future trials must be compared’
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Tom Powles
@tompowles1
Aug 28, 2024
The EMA has approved Enfortumab Vedotin and pembrolizumab for 1st line urothelial cancer. It supersedes 1st platinum based therapy as the new standard of care in Europe. astellas.com/en/news/29371?…
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Tom Powles
@tompowles1
Oct 18, 2025
1/2 KN905 Enfortumab Vedotin + Pembro continues to transform bladder cancer in spectacle fashion. In cisplatin ineligible operable disease it beats cystectomy with EFS HR 0.4, OS HR 0.5. pCR of 57% is much ⬆️ than anything before #ESMO25 pCR> 50% questions unselected surgery
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Tom Powles
@tompowles1
Sep 15, 2024
Perioperative durvalumab + neoadjuvant chemo & cystectomy in operable bladder cancer significantly delays (HR 0.68) event free survival and a 25% reduction in the risk of death. 10% ⬆️ pCR. It’s the 1st time immune therapy has an OS benefit in muscle invasive UC #ESM024 @NEJM
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Tom Powles
@tompowles1
Feb 12, 2021
Enfortumab Vedotin showing a significant 30% reduction in the risk of death compared to chemotherapy in chemo and immune therapy pretreated advanced urothelial cancer. RR=40%. A new class of drug + significant OS means this will now be widely used globally IMO @NEJM @ASCO #GU21
Tom Powles
@tompowles1
Nov 25, 2023
Treatment for muscle invasive bladder cancer will change if the ongoing R3s are +ve. Neoadjuvant IO/ADC combination, bladder sparing approaches, intravesical therapy (TAR200) & ctDNA will improve outcomes and spare patients unnecessary treatments. This is the next chapter IMO.
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Tom Powles
@tompowles1
Sep 22, 2023
EV302- enfortumab vedotin and Pembrolizumab met its dual primary endpoints of OS and PFS with ‘clinically meaningful’ improvement versus chemotherapy in patients with previously untreated la/mUC.
merck.com
Merck Announces Phase 3 KEYNOTE-A39/EV-302 Trial Met Dual Primary Endpoints of Overall Survival...
First Phase 3 results for the KEYTRUDA® (pembrolizumab) and Padcev® (enfortumab vedotin-ejfv) combination showed a statistically significant and clinically meaningful improvement in OS, PFS and key...
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Tom Powles
@tompowles1
Aug 18, 2025
IMVIGOR011: Atezo vs placebo in ctDNA+ve bladder ca (including -ve becoming +ve) post cystectomy hit OS/PFS. It also tracks outcomes in the ctDNA-ve, supporting a ctDNA adjusted approach. It’s been a long journey for atezo in UC but it has +ve OS at last natera.com/company/news/i…
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Tom Powles
@tompowles1
Mar 13, 2024
New @myESMO guidlines for advanced bladder cancer @Annals_Oncology. Enforumab Vedotin & pembro is the new standard of care. Platinum therapy is now 2nd line and eligibility less relevant. Gem/cis/nivo or maintenance avelumab for pts where EVP not available annalsofoncology.org/article/S0923-…
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Tom Powles
@tompowles1
Dec 10, 2020
ctDNA positivity after cystectomy for muscle invasive bladder cancer identifies a high risk of relapse. These patients have a survival benefit with adjuvant atezolizumab. ctDNA-ve patients have low risk of relapse and don’t benefit from atezo. ctDNA clearance in ~20 #ESMOImmuno20
Tom Powles
@tompowles1
Jan 27, 2024
Adjuvant pembro ⬆️ DFS (0.69) but ❌ OS (0.98) in UC, ~10% tox ++. Atezo also had ❌ OS. Nivo had 0.7 DFS but no OS data after ++ years-assuming it’s +ve seems unwise. Without OS we’re over treating. Adjuvant IO in all comers is on shaky ground without more data IMO #GU24
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Tom Powles
@tompowles1
Jun 25, 2024
Positive results from the NIAGARA Phase III trial showed durvalumab with neoadjuvant chemo then cystectomy had a statistically significant and clinically meaningful improvement in EFS & OS versus chemo/cystectomy alone in muscle invasive bladder cancer astrazeneca.com/media-centre/p…
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