Neha Vapiwala, MD, on prostate cancer trends highlighted at ASCO GU 2026

In the following video, Neha Vapiwala, MD, FASTRO, outlines key trends in prostate cancer care that were highlighted during the 2026 ASCO Genitourinary Cancers Symposium in San Francisco, California. Vapiwala is a professor of radiation oncology at University of Pennsylvania, the dean of admissions and vice chair of education in the department of radiation oncology at the Perelman School of Medicine, and the president of ASTRO.

Vapiwala began by highlighting a continued shift toward more personalized care in prostate cancer, with emerging data reinforcing the importance of tailoring treatment strategies to individual patient characteristics. Advances in biomarker development, including genomic, imaging, and combined approaches such as radiomics, are helping clinicians better define which patients may benefit from treatment intensification vs those who could safely undergo de-escalation. This move away from a “one-size-fits-all” paradigm reflects a broader oncology trend toward precision medicine and more nuanced clinical decision-making.

Vapiwala noted that some of the data presented may be practice-changing, while other findings serve to reaffirm current approaches already adopted in clinical practice. A key focus is balancing oncologic outcomes with patient-centered considerations, particularly quality of life. As clinicians incorporate increasingly sophisticated tools to stratify risk and guide therapy, there is a growing emphasis on aligning treatment intensity with patient goals and preferences, ensuring that therapeutic decisions are both evidence-based and individualized.

Another major theme from the meeting was the expanding role of radiopharmaceutical therapies in prostate cancer. These agents have already demonstrated meaningful clinical benefit in advanced disease settings, reshaping treatment paradigms for patients with limited options. Ongoing research is now exploring their use earlier in the disease course, including in combination with other therapies and in patients with lower disease burden. This strategic repositioning aims to enhance efficacy while maintaining safety, signaling a potentially important evolution in how radiopharmaceuticals are integrated into prostate cancer care.