#Urologist @UniklinikUlm, Germany @GeSRU_de Views are my own.
Ulm, Germany
Joined July 2015
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Angelika Mattigk retweeted
ctDNA analysis from the EVP vs chemotherapy muscle invasive bladder cancer trial (B15/EV304) shows ctDNA is strongly prognostic at all time points for both arms. EVP has higher clearance rates across time points, underlining its ⬆️ activity. Results for the control arm are strikingly similar to the ctDNA results in the chemo control arm in the NIAGARA trial. This consistency underlines the utility of ctDNA from a prognostic perspective.#ESMO26 @OncoAlert
Angelika Mattigk retweeted
Longer follow up of LS-11 showed lenvatinib/belzutifan vs cabozantinib did not reach significant OS HR 0.85 (0.70-1.03). #ESMO26 Other endpoints of RR (54%) and DFS (HR 0.75) remain positive and impressive. TRAEs are 73% vs 66%. This is the most robust 2nd line strategy IMO, as many patients don’t make it to 3rd line. Nevertheless the lack of OS means other sequencing strategies seem reasonable. @DrDanielHeng @OncoAlert
Angelika Mattigk retweeted
VOLGA explored short periods of EV (3 cycles) with duvalumab in muscle invasive bladder cancer #ESMO26 @NEJM. Results showed EVD was associated with better EFS + OS vs cystectomy alone (0.51 and 0.58 respectively). pCR 40-45% with ctDNA clearance rates of 60%. High rates of adjuvant IO therapy uptake and low rates of neuropathy suggest potential advantages of this approach which focuses the ADC in the neoadjuvant phase. It’s likely to be attractive for patients.
Angelika Mattigk retweeted
EMA approval of perioperative EVP in cisplatin ineligible muscle invasive bladder cancer occurred today.
This is a big step towards curing more patients
Extension to cisplatin eligible patients soon - we hope (based on +ve OS in B15 study)
Bladder surgery sparing trials next (EV209 and 309)
newsroom.astellas.com/2026-0…
Angelika Mattigk retweeted
🔁 EV → progression → now what? The defining sequencing question in #BladderCancer 2026 🧬 and beyond.
The “rechallenge with same target” debate is more nuanced than we admit 👇
Option A: Keep targeting Nectin-4, swap the payload:
LY4052031 (NEXUS-01): 33% ORR even in EV-pretreated pts with a novel topoI payload. Preclinical data suggest EV resistance may be driven by P-glycoprotein payload efflux, supporting continued Nectin-4 targeting via ADCs with alternative payloads.
‼️ Target-related resistance might play a role too!!
🔗 urotoday.com/conference-high…
Option B — Switch the target entirely:
Disitamab vedotin (RC48) → HER2, but ~55% ORR in EV-naïve pts only; a post-EV role is unlikely - same payload.
➡️ Trastuzumab deruxtecan could however be an option! But data are missing post-EV.
Iza-Bren (BL-B01D1) → EGFR×HER3 bispecific ADC: 44.1% cORR & 88.2% DCR in pretreated aUC. A rational fit for basal-squamous biology (high EGFR) while also tackling the luminal spectrum via HER3 - exactly the subtype that does WORSE on EVP (basal squamous) is targeted!
Or just go for TROP2, which is abundantly expressed across all UCs (except sarcomatoid and neuroendocrine UC)?
So the real question isn’t “rechallenge: yes or no?” 👇
⁉️ Is it a PAYLOAD problem (efflux → new payload wins) or a TARGET problem (antigen loss → new target wins) or sometimes both?
⁉️ Should subtype + resistance mechanism — not just availability — drive 2nd-line ADC choice?
We’re moving from “one ADC fits all” to mechanism-informed sequencing. The biology has to lead in the future 🎯
@niklas_kluemper @PGrivasMDPhD @drenriquegrande @braegelmannlab @ViktorGruenwald @Dr_Aggen @MichalSternsch @DrRosenbergMSK @jonchou05 @PowlesTom @PTarantinoMD @DrChoueiri @Uromigos @nachoduranm @montypal @shilpaonc @apolo_andrea @urotoday @OncoAlert @weoncologists @zklaassen_md @yao_zhu_sh @myESMO @Uroweb @Uromigos
#ADC #BladderCancer #UroOncology #Nectin4 #HER2 #EGFR #HER3 #IzaBren #EnfortumabVedotin #DisitamabVedotin #PrecisionOncology #ASCO26 #Sequencing #BasalSquamous
Angelika Mattigk retweeted
very happy to share our lab's latest work, published today in @Cancer_Cell : sciencedirect.com/science/ar…. We show that we can decompose pathology images of cancer tissue into their constituent parts, measure tissue patterns with AI, and that these tissue patterns (1/n)
Angelika Mattigk retweeted
JUST In: TALAPRO-3 published in @NEJM
Adding #talazoparib to enzalutamide/ADT
=>3-year rPFS: 77% vs 56% in HRR-deficient metastatic prostate cancer !
Looking forward to full presentation by @neerajaiims who keeps changing SOC, one trial at a time.
@ASCO #ASCO26 @OncoAlert
Angelika Mattigk retweeted
Original Article: Daraxonrasib or Chemotherapy in Previously Treated Metastatic Pancreatic Cancer (phase 3 RASolute 302 trial) nej.md/4nWaxvM
#ASCO26 | @ASCO
ALT A two-panel line graph shows overall survival in two populations, comparing darovasertib (blue line) and chemotherapy (gray line) treatments. Panel A depicts the RAS G12 population, while Panel B shows the overall population. Hazard ratios and confidence intervals are detailed in each panel.
ALT This image shows two line graphs titled "Progression-free Survival in the RAS G12 Population" and "Progression-free Survival in the Overall Population." Both graphs compare survival rates over 13 months between two groups: one receiving darovasertib and the other receiving chemotherapy. Accompanying the graphs are tables detailing the number of events and patients at risk for each treatment group.
Angelika Mattigk retweeted
POTOMAC QOL: A year of durvalumab with BCG shows a delay in DFS and is FDA approved #ASCO26 . Here durvalumab appears to have little effect on QOL. We know ICIs have a ~10% rate of life changing toxicity (~10% @BethN01 ) which ⬇️QOL. New tools/methods are needed to unpick the details for patients.
Angelika Mattigk retweeted
🔄 Can you rechallenge with Enfortumab Vedotin after progression? New real-world data from @MichalSternsch @MSKCancerCenter at #ASCO2026 says: in some yes - promising in patients with prior EV benefit & EV-free interval >6 months. 📊 55 pts, ORR 25%, median OS 15.2 months. | Abstract 547088, Poster A57 #mUC #BladderCancer #Immunotherapy
Angelika Mattigk retweeted
🚨 TALAPRO-3: PARP inhibition moves earlier in mHSPC
Just out in @NEJM
🧬 599 pts w/ metastatic HRR-altered hormone-sensitive #prostatecancer randomized to talazoparib + enzalutamide vs enzalutamide alone.
📉 52% reduction in risk of radiographic progression or death (HR 0.48, P<0.001). 3-year rPFS: 77% vs 56%.
🎯 Benefit was strongest in BRCA1/2-altered disease (HR 0.37), but remained significant in non-BRCA HRR alterations (HR 0.57).
⏳ Fewer patients required subsequent therapy (HR 0.51) and PSA progression was delayed (HR 0.51).
❤️🩹 OS trend favored talazoparib (HR 0.77), but data remain immature.
🩸 Toxicity remains the tradeoff: Grade ≥3 anemia in 51%, transfusions in 40%, and 2 treatment-related deaths.
#ASCO26 @ASCO @PCFnews @PCF_Science @neerajaiims
🔗shorturl.at/7lL8W
Angelika Mattigk retweeted
The 3.5yr OS from EV302 continues to show transformative benefit (HR 0.53 (0.45-0.63)) #ASCO26 for EV/pembro. The landmark OS for the CR population (30%) is ~90%. Median time to CR is 4.5 months (responses mature over time). Response rates of platinum chemo after EVP is 21% (OS 11 months). This should be considered a 2nd line standard. Median duration of EV was 7 months - longer in responders. Optimal duration of EV trials are needed. @OncoAlert
Angelika Mattigk retweeted
JUST OUT at #ASCO26 with a concomitant Publication in the New England Jouranal of Medicine: TALAPRO 3 :PARP and Androgen-Signaling Inhibition plus ADT in Metastatic Prostate Cancer
by our dear friend and OncoAlert founding faculty @neerajaiims 🚨
buff.ly/gk9AuvF
In this phase 3 trial of patients with metastatic androgen pathway modulation–sensitive #prostateCancer and homologous recombination repair gene alterations, adding talazoparib to enzalutamide significantly improved imaging-based progression-free survival versus enzalutamide alone (3-year rates: 77% vs. 56%; HR 0.48, P<0.001). An interim overall survival analysis favored talazoparib but was not definitive. Toxicity was higher with talazoparib, particularly grade ≥3 anemia, with two treatment-related deaths reported.
@neerajaiims
@AzadOncology
@quimmateo
@nealshore
@cvulsteke
@montypal @crisbergerot @DrDanielHeng @apolo_andrea @DrChoueiri @PGrivasMDPhD @TiansterZhang @HHammersMD @ravikanesvaran @neerajaiims @amerseburger @sonpavde @drenriquegrande @scserendipity1 @Silke_Gillessen
@EfstathiouEleni @tompowles1 @BraunMDPhD @nataliagandur @cdanicas @brian_rini @AOmlin @yekeduz_emre @DrYukselUrun
@nataliagandur @realbowtiedoc @AmandaNizamMD @scocmem
Angelika Mattigk retweeted
Perioperative EV +pembo vs cystectomy (KN905) in MIBC shows great OS & pCR >50%. Quality of life data can be difficult to interpret due to multiple tools & different time points for analysis. Results did not show differences in the 2 arms at week 18 time point. Cystectomy had a more dramatic effect on QOL rather than EVP, but EVP will have both short term and long term side effects. While the methods used here are standard and well presented it feels there maybe a better way of assessing QOL. #ASCO26
Angelika Mattigk retweeted
Bladder cancer highlights #ASCO26
1) Data for 3 Nectin4/Topo1 ADCs showing efficacy (LY4052031 , LY4101174, SHR-A2102). Can we sequence these drugs after EV? 2) Data from EV302/303 for EVP showing longer term outcomes and QOL 3) adjuvant QOL data for adjuvant pembro (AMBASSADOR) or atezo (IM011) 4) updated data for durvalumab in MIBC (with RT) & NMIBC (POTOMAC). @OncoAlert
Angelika Mattigk retweeted
KIM-1 in oligometastatic ccRCC.
KIM-1 and ctDNA are independently prognostic.
@DrChoueiri @VincentWenxinXu @PavlosMsaouel @lilli_ash @Clara__Steiner #GU26 @EUplatinum @ASCO @OncoAlert
Angelika Mattigk retweeted
There has been a lot of data on ctDNA in bladder cancer #GU26, but less on tumor DNA in the urine (utDNA). In this informed utDNA analysis from NIAGARA we show extensive utDNA positivity at baseline & clearance with neoadjuvant therapy. There is also a better correlation with utDNA and pCR than with ctDNA. This dual approach helps determine the origin of thr MRD (local vs systemic). False positive rates at CR need addressing. Clearance could be a marker of local therapy activity #GU26 @MichvdHeijden @MattGalsky
Angelika Mattigk retweeted
KN-B15/EV303: R3 Perioperative EVP vs Gem/cis in MIBC shows EFS HR 0.53 (0.41–0.70), OS HR 0.65 (0.48-0.89), pCR 56% vs 33%, G3+ tox 76% vs 67% #GU26. About half the patients completed 9 cycles of EVP. These are great results. Gem/cid is harder to beat when not all patients are at risk of relapse. Bladder sparing approaches for cCR (~60%) will be where this ends. ‘EVP 1st, ask questions later’. These studies are needed soon.
Angelika Mattigk retweeted
The standard of care for MIBC will now include perioperative EVP for both cisplatin eligible and ineligible #BladderCancer pts. The EV304 study presented today @MattGalsky shows an improvement in EFS (HR 0.53) and OS (HR 0.65) for EVP over GC. @ASCO #GU26
