ASCO 2026: 3 key themes shaping the future of GU oncology

In this video, María Natalia Gandur Quiroga, MD, MSc, of the Instituto de Oncología Ángel H. Roffo in Buenos Aires, Argentina, discusses 3 major themes in genitourinary (GU) oncology from the 2026 American Society of Clinical Oncology Annual Meeting: smarter treatment selection, the value of negative trials, and the challenges of implementing advances in clinical practice.

The first major theme was smarter treatment selection across GU malignancies. She explained that in prostate cancer, the focus has shifted from simply intensifying treatment to identifying which patients truly benefit from perioperative or systemic intensification while avoiding unnecessary toxicity.

“In kidney cancer, the adjuvant space is becoming more nuanced with immunotherapy, ctDNA, and risk stratification all becoming part of the conversation,” Gandur Quiroga explained. “In urothelial cancer, we are seeing durability data with enfortumab vedotin plus pembrolizumab in metastatic disease, while perioperative and bladder preservation strategies continue to evolve.”

The second theme was the importance of negative or non-confirmatory trials in advancing clinical practice. Gandur Quiroga highlighted the RADICAL trial (NCT04071223) in renal cell carcinoma (RCC) with bone metastases, in which adding radium-223 to cabozantinib did not improve symptomatic skeletal event-free survival despite a strong biologic rationale. Although the findings do not support the treatment strategy evaluated, the results underscore the ongoing unmet need for effective approaches to managing bone metastases in RCC.

Related: Radium-223 fails to improve skeletal event-free survival in metastatic RCC

The third major theme was implementation of new advances in the real-world setting. Gandur Quiroga emphasized that translating these developments into practice requires access to molecular testing and ctDNA assays, multidisciplinary expertise, novel systemic therapies, surgery and radiotherapy, as well as careful toxicity management. Ultimately, she said, the goal is not simply to deliver more treatment, but to provide the right treatment to the right patient at the right time.