Petros Grivas, MD, PhD – Championing Academic Partnership, Mentorship for Meaningful Change in Bladder Cancer

Petros Grivas, MD, PhD, is a distinguished professor in the Clinical Research Division of Fred Hutchison Cancer Center. He is also a professor and the clinical director of the Genitourinary Cancers Program at the University of Washington School of Medicine. His primary research focus centers on the development of novel therapies and biomarkers in bladder cancer.

In this exclusive interview with GU Oncology Now, Dr. Grivas shares profound insights into his career trajectory, driven by a passion to address unmet needs and revolutionize and transform the care of patients in bladder cancer. Delving into pivotal moments and inspirations that shaped his path, Dr. Grivas discusses the transformative impact of clinical trials, highlights his role as a clinical director, and offers visionary perspectives on the future of genitourinary (GU) oncology, including advancements in personalized and precision oncology, genomic profiling, and collaborative efforts between academic and community oncology practices.

Why did you become a GU oncologist? What was your inspiration to go into this field?

Dr. Grivas: It is so exciting to be a genitourinary medical oncologist, especially in the current era. When I started my fellowship in oncology in the summer of 2010 at the University of Michigan, I was intrigued by the urgent, unmet need to develop new, safe, and effective therapies to prolong the lives of patients with GU malignancies. At that time, 14 years ago, there were very few advancements and there was a notable stagnancy in the field of bladder cancer. It was a compelling opportunity for me to contribute meaningfully to the needed change and help improve outcomes for patients. The main driver for me was this unmet need, especially in bladder cancer.

The variety of tumor types in GU oncology was another factor that drew me in. We see patients with bladder cancer, upper tract urothelial cancer, urethral cancer, as well as prostate (most common cancer in men), kidney, and testicular cancers. Being able to potentially cure many patients was very motivating; there is variety of tumors across different stages with varying chances of cure. Additionally, the mentorship I received during my fellowship played a crucial role. I had the privilege of being mentored by exceptional clinicians and researchers, which further fueled my passion for the field. The GU Oncology program and my wonderful clinical and lab mentors at the University of Michigan played a vital role in my training, career decisions, and my growth as an oncologist, scientist, investigator.

Lead us down the path of carving out your role as a renowned researcher and expert GU oncologist, beginning with the University of Michigan and ending up at Fred Hutch.

Dr. Grivas: I was committed to becoming a GU medical oncologist early in my fellowship, driven by the clinical and research needs, and also the opportunities and mentorship available. As I progressed through my fellowship, I was fortunate to have valuable experiences in both clinical research and translational science. However, as my fellowship ended, I had to make a significant decision between pursuing a career focused on clinical investigation or one focused on lab-based translational science. My passion for direct patient care and the immediate impact it provides led me to choose clinical investigation as my primary career pathway, while I still “speak the lab language,” which is useful for collaborations.

After completing my fellowship, I joined the faculty at the University of Michigan, where I continued my work in clinical research, education and patient care. A year later, I moved to the Cleveland Clinic, attracted by similar opportunities for growth and leading the bladder cancer program in a very strong, supportive and well-functioning clinical environment; this was a spectacular experience. Eventually (January 2018), I transitioned to Fred Hutch and University of Washington School of Medicine in Seattle, where I have been serving as the clinical director of the GU Cancers Program. This role allows me to focus on further refining clinical operations, defining vision, strategic plan and program growth, helping with community outreach, and optimizing patient care and access across both Fred Hutch and the University of Washington clinic sites.

You mentioned designing your first clinical trial in 2011 and working on important bladder cancer trials. Can you provide some background on those trials and their significance in your career?

Dr. Grivas: Clinical trials play a crucial role in advancing our understanding and treatment of cancers across the board; this is how progress is made. During my fellowship, I had the opportunity to work on several interesting clinical trials, one of which focused on switch maintenance therapy in the frontline setting of advanced urothelial cancer (with my mentor at that time, Dr. Maha Hussain). Although the trial results were negative, it prompted further exploration of switch maintenance therapy strategies, leading to the design of the JAVELIN Bladder 100 trial together with excellent colleagues from other centers. That trial, which investigated the use of avelumab as switch maintenance therapy following disease control with platinum-based chemotherapy, changed the frontline treatment landscape for advanced urothelial carcinoma, demonstrating improved survival outcomes without compromising quality of life.

I also was involved in a great team for the development of sacituzumab govitecan, an antibody-drug conjugate targeting TROP-2 in urothelial cancer cells. This drug showed very promising results in patients with prior chemotherapy and immunotherapy in a phase 2 trial, leading to its accelerated approval by the US Food and Drug Administration. Such clinical trials represent collaborative efforts involving multidisciplinary teams, and they have been instrumental in advancing treatment options for patients with GU cancers.

Can you tell us about your role as the clinical director of the GU Cancers Program at University of Washington Medicine and how you balance responsibilities between Fred Hutch and the University of Washington?

Dr. Grivas: As the clinical director, my primary focus is overseeing clinical operations and program growth within the GU Cancers Program at Fred Hutch and University of Washington School Medicine. This role involves collaborating with multidisciplinary teams to optimize patient care, expand clinical research initiatives, and enhance community outreach efforts. Additionally, I work closely with the clinical research director to ensure seamless integration of research activities to clinical operations across both Fred Hutch and the University of Washington clinic sites, while we also develop strategies to remove barriers for further growth.

Administration and leadership require ongoing learning and growth, and I have actively pursued opportunities for leadership development through the ASCO® Leadership Development Program and various other leadership courses. Balancing responsibilities between Fred Hutch and the University of Washington requires effective and efficient time management and “dynamic” prioritization, with a focus on advancing patient care, educational and research initiatives.

What do you foresee as the biggest changes in GU oncology patient care over the next 5 to 10 years?

Dr. Grivas: In the coming years, I anticipate significant advancements in GU oncology patient care, driven by ongoing research and technological innovations. Clinical trials will continue to play a critical role in testing novel therapies and treatment approaches, with a focus on personalized medicine and targeted therapies. Additionally, further advancements in genomic profiling, biomarkers and artificial intelligence have the potential to revolutionize diagnosis, treatment selection, and disease monitoring.

I also foresee a greater emphasis on bladder preservation strategies and potentially preventive/screening measures, as well as increased collaboration between academic institutions and community oncology practices to improve access to cutting-edge treatments and “pragmatic” clinical trials. Overall, I believe these developments and collaborations, along with available funding and support, will lead to further improved outcomes and quality of life for patients with GU cancers.