ASCO GU 2026 deep dive: Practice-changing data from the genitourinary cancers symposium
Last week’s ASCO Genitourinary Cancers Symposium in San Francisco brought together the field’s leading oncologists, researchers, and innovators to share practice-changing data and highlight the future of genitourinary cancer care.
The symposium highlighted major advances in bladder and prostate cancer care, along with emerging therapeutic strategies in renal cell carcinoma—all aimed at improving patient outcomes.
Below, we break down the research behind the conference’s most important takeaways.
Breakthroughs in bladder cancer treatment
New data from the phase 3 BOND-003 Cohort C trial showed major advances in the treatment of non–muscle-invasive bladder cancer: Oncolytic immunotherapy (intravesical cretostimogene grenadenorepvec) achieved a 75.5% complete response rate in patients with high-risk, Bacillus Calmette-Guérin (BCG)-unresponsive bladder cancer with carcinoma in situ, which is notoriously difficult-to-treat.[] Cretostimogene is a type of oncolytic immunotherapy designed to directly kill cancer cells and activate the immune system.[] It was well tolerated and consistently effective.
A phase 2 study examined HER2 expression as an independent predictor of poor response to BCG therapy.[] It found disitamab vedotin, an anti-HER2 antibody-drug conjugate, combined with intravesical electromotive mitomycin (a way of delivering chemotherapy via electric currents) in patients with HER2-expressing, high-risk non–muscle-invasive bladder cancer was effective and tolerated. It may serve as an alternative to BCG therapy, which can prevent the need for a cystectomy.
Disitamab vedotin, combined with toripalimab, a PD-1 inhibitor, showed “significant and clinically meaningful” improvement in both progression-free survival and overall survival in patients with untreated, HER2-expressing, advanced urothelial cancer in a new trial.[]
Results from a phase 2 trial of pembrolizumab (P) in patients with muscle-invasive bladder cancer (MIBC)—who are cisplatin-ineligible or cisplatin-declining—showed transurethral resection of bladder tumor (TURBT) followed by pembrolizumab monotherapy showed a stringent clinical complete response in 43% of patients, allowing patients to avoid cystectomy.[]
New advances in metastatic prostate cancer treatment
New research showed that in patients with de novo metastatic castration-sensitive prostate cancer (mCSPC) who are elderly, frail, or who have high comorbidities, androgen receptor pathway inhibitors, combined with androgen-deprivation therapy (ADT), vs ADT alone, extended median survival by nearly 10 months.[]
A randomized phase 3 ASPIRE trial found that in patients with metastatic castration-sensitive prostate cancer (mCSPC), adding docetaxel to ADT plus apalutamide vs ADT alone plus apalutamide may improve survival. Oncologists should note that this trial is currently enrolling patients.[]
A study of men with metastatic castration-resistant prostate cancer (mCRPC) compared post-taxane and post-ARPI therapy with either olaparib or lutetium-177-PSMA-617 (known as Pluvicto, a targeted radioligand therapy).[] Lutetium-177-PSMA-617 was associated with longer survival than just olaparib, especially in patients who had prior ARPI therapy.
An analysis of over 5,000 patients with mCRPC treated between 2021 and 2025 revealed 80% of patients received androgen receptor pathway inhibitors (ARPIs) as first-line therapy.[] Taxane chemotherapy remained common in other lines of therapy. In later therapy lines, patients were given PARP inhibitors and lutetium-177-PSMA-617 (Pluvicto), illustrating the expanding treatment landscape.
Despite therapeutic options, not every patient goes on to receive second-line therapy.[] The same analysis found that only about 50% of mCRPC patients received any second-line therapy, with attrition rising through lines of therapy.
Emerging topics in renal cell carcinoma
Researchers presented findings from a pilot phase 1 trial in which patients with renal cell carcinoma (RCC) were given implantable microdevices (IMDs) used to administer multiple drugs directly into tumors.[] This approach was found to be both safe and feasible, suggesting IMDs could be an effective way to evaluate a given drug in vivo without causing overall toxicity to the patient.
Researchers also spotlighted the gut microbiome as a promising target in metastatic renal cell carcinoma (mRCC). Data presented examined two randomized phase 1 trials in which patients with mRCC were given biotherapeutic Clostridium butyricum, a probiotic bacterium, in addition to immune checkpoint inhibitor (ICI)–based therapy.[] They found Clostridium butyricum significantly improved outcomes. More so, they found altering the microbiome with Clostridium butyricum may be particularly impactful when combined with dual ICI regimens.
Speaking of dual ICI therapy, oncologists presented findings from a dose-escalation study in which Clostridium butyricum was combined with nivolumab/ipilimumab in treatment-naive mRCC across three dose levels.[] No dose-limiting toxicities were observed. The treatment appeared to change the gut microbiome in a dose-dependent way, meaning the more Clostridium butyricum was given, the better the effect.