María Teresa Bourlon, MD, MS, FASCO, previews practice-changing research at ASCO GU 2026

In this preview of research expected at the 2026 ASCO Genitourinary Cancers Symposium, medical oncologist María Teresa Bourlon, MD, MS, FASCO, outlined major clinical advances anticipated across prostate, urothelial, kidney, and testicular cancers. Speaking from her practice at the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico, she emphasized that the meeting will focus heavily on survival outcomes, biomarker-guided therapy, and emerging treatment mechanisms.

Prostate cancer will dominate early discussions, particularly updated overall survival analyses from several important trials. These include final results from PEACE-3 (NCT02194842) evaluating enzalutamide (Xtandi) with or without radium-22 (Xofigo) in metastatic castration-resistant prostate cancer, as well as outcomes from BRCAWay comparing abiraterone acetate (Zytiga), olaparib (Lynparza), and combination approaches in patients with DNA repair defects. Updated survival data are also expected in localized disease, examining radiation strategies such as external beam radiotherapy boosts vs brachytherapy (ASCENDE-RT). Together, these studies may refine both systemic and local treatment standards.

Attention will also shift toward earlier disease settings. The phase 3 PEACE-2 study (NCT01952223) exploring androgen deprivation therapy and radiotherapy with or without cabazitaxel (Jevtana) in very high-risk localized prostate cancer will help clarify whether chemotherapy adds meaningful benefit before metastatic progression. Investigators will additionally present early-phase research on a novel prostate-specific membrane antigen-targeted T-cell engager, signaling continued expansion of immunologic and targeted strategies. Quality-of-life analyses from the phase 3 PSMAddition study (NCT04720157) combining ¹⁷⁷Lu-PSMA-617 (Pluvicto) therapy with hormone-based treatment are expected to address concerns about toxicity and patient-reported outcomes. First-in-human data from the phase 1 PAnTHa study (NCT06217822) involving actinium-based PSMA targeting further highlight the growing role of next-generation radioligand therapies.

In urothelial carcinoma, several studies may reshape perioperative management of muscle-invasive bladder cancer. The phase 3 KEYNOTE-B15 trial (NCT04700124) evaluating neoadjuvant and adjuvant enfortumab vedotin-ejfv (Padcev) plus pembrolizumab (Keytruda) in cisplatin-eligible patients could challenge chemotherapy-based standards. The phase 2 RC48G001 (NCT04879329) trial will explore antibody–drug conjugates in HER2-expressing disease, expanding targeted treatment options for previously treated patients.

Biomarker development is another central theme. Multiple analyses will evaluate circulating tumor DNA (ctDNA) as a tool to guide therapy selection and monitor response, including trials assessing ctDNA-directed adjuvant immunotherapy. Investigators will also examine urinary tumor DNA alongside blood-based biomarkers, reflecting a broader shift toward molecularly informed treatment decisions. Combination immunotherapy strategies, including co-formulated checkpoint inhibitors, will be tested in advanced disease, while bladder-preserving approaches using immunotherapy combined with chemoradiation aim to reduce the need for cystectomy in selected patients. Updated pathological and disease-free survival outcomes are also expected from trials in cisplatin-ineligible populations.

Kidney cancer is anticipated to be a major highlight later in the meeting. The phase 3 LITESPARK-011 trial (NCT04586231) evaluated belzutifan (Welireg) plus lenvatinib (Lenvima) vs cabozantinib (Cabometyx) for advanced renal cell carcinoma (RCC) following anti–PD-(L)1 treatment. Regimens of adjuvant pembrolizumab plus belzutifan vs lenvatinib in clear cell RCC were evaluated in the phase 3 LITESPARK-022 trial (NCT05239728). Investigators will also present patient-reported outcomes from the phase 3 RAMPART trial (NCT03288532), addressing an increasingly important question: How treatment intensity affects long-term quality of life in patients with potentially curable disease.

Finally, testicular cancer, a field with relatively fewer recent advances, will feature emerging biomarker research. Early results from the CLIMATE prospective cohort study will assess microRNAs as markers of minimal residual disease in patients with stage I disease, with the goal of improving surveillance strategies and identifying relapse earlier while avoiding overtreatment.

Overall, Bourlon highlighted a clear trend across genitourinary oncology: movement toward precision medicine through biomarkers, expansion of immunotherapy and antibody-drug conjugates, and increasing attention to survivorship and quality-of-life outcomes. The 2026 symposium is expected to provide data that could influence standards of care across multiple disease stages while introducing innovative therapeutic mechanisms poised to shape future research.