Top takeaways from ASCO GU: Your 3-minute brief
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.
Here’s what’s making the biggest impacts.
Breakthroughs in bladder cancer treatment
Bladder cancer management is entering a pivotal stretch, with phase 2 and 3 data reshaping what’s possible for patients who historically had few durable options. From BCG-unresponsive non–muscle-invasive disease to untreated, HER2-expressing advanced urothelial carcinoma, novel intravesical strategies and antibody-drug combinations are delivering response rates and survival gains that could meaningfully alter the treatment algorithm.
What it means for your practice
BCG-unresponsive NMIBC: Intravesical cretostimogene grenadenorepvec may soon offer a high–complete response, bladder-sparing option for patients with carcinoma in situ.
HER2 testing is increasingly actionable: HER2 expression may guide treatment selection in both non–muscle-invasive and advanced disease.
BCG alternatives are emerging: Disitamab vedotin–based strategies could reduce reliance on BCG and lower cystectomy rates in select patients.
Frontline advanced disease: Disitamab vedotin plus toripalimab may represent a new standard contender for untreated, HER2-expressing urothelial carcinoma.
Cisplatin-ineligible MIBC: TURBT followed by pembrolizumab offers a potential bladder-preserving pathway for carefully selected patients.
New advances in metastatic prostate cancer treatment
Prostate cancer treatment sequencing continues to evolve, and new data are sharpening how we approach frail patients, intensification strategies in mCSPC, and therapy selection after ARPI and taxane exposure. Across disease states, the message is clear: Survival gains are achievable, but only if patients make it to the next line of therapy.
What it means for your practice
Don’t withhold ARPI intensification based on age or frailty alone in de novo mCSPC; survival benefit extends to higher-risk, comorbid populations.
Triplet therapy (ADT + apalutamide + docetaxel) is under active investigation and may further shift first-line standards.
In post-ARPI mCRPC, PSMA-targeted radioligand therapy (lutetium-177-PSMA-617) may offer greater survival benefit than PARP inhibition alone in appropriate patients.
Sequence planning matters early: Attrition rates highlight the importance of optimizing first- and second-line decisions before performance status declines.
Emerging topics in renal cell carcinoma
Renal cell carcinoma research is pushing beyond conventional systemic therapy—into intratumoral drug testing and microbiome modulation. Early-phase data suggest that both precision delivery platforms and targeted manipulation of gut flora may enhance response while limiting toxicity, particularly in combination with immune checkpoint inhibitors.
What it means for your practice
Intratumoral implantable microdevices may offer a future pathway for real-time, patient-specific drug sensitivity testing in RCC without systemic exposure.
Microbiome modulation is emerging as a therapeutic lever in mRCC, particularly alongside ICI-based regimens.
Clostridium butyricum plus nivolumab/ipilimumab appears safe in early testing and may enhance dual checkpoint blockade activity.
Dose-dependent microbiome shifts suggest that microbial engineering could become a measurable and adjustable component of immunotherapy optimization.
Looking for a deeper dive into the top takeaways from ASCO GU? Read this next: ASCO GU 2026 deep dive: Practice-changing data from the genitourinary cancers symposium