The fourth week of July brought together important updates across GU oncology, with expert posts covering prostate cancer, bladder cancer, upper tract urothelial carcinoma, metastatic castration-sensitive and castration-resistant prostate cancer, muscle-invasive bladder cancer, and non-muscle-invasive bladder cancer.
This week’s selection includes updates on the evolving role of digital rectal examination in prostate cancer screening and staging, blood-accessible biomarkers in prostate cancer radiotherapy, EV-304 and perioperative treatment strategies in muscle-invasive bladder cancer, quality-of-life findings from EMBARK in high-risk biochemical recurrence, and HER2 as a biomarker and therapeutic target in advanced urothelial carcinoma.
Other posts highlight ⁶⁸Ga-PSMA-11 PET imaging for identifying patients with mCRPC who may be suitable for lutetium-177 rosopatamab tetraxetan, FDA Priority Review for an investigational PARP inhibitor plus ARPI combination in HRR gene-mutated mCSPC, relative dose intensity of cisplatin-based neoadjuvant chemotherapy in muscle-invasive urothelial cancer, the MSC–TIMP1–RAP1 axis in bladder cancer progression, and dual-energy CT radiomics for predicting tumor grade in NMIBC.
Together, these posts reflect the continued evolution of GU oncology across screening, staging, biomarker development, radiotherapy, molecular imaging, perioperative treatment, neoadjuvant chemotherapy, targeted therapy, precision oncology, quality of life, and noninvasive risk assessment.
Juan Gómez Rivas — Urologist at Hospital Clínico San Carlos; Director of ICUA La Milagrosa; Associate Professor at UCM; ESU/ESOU Board Member | Spain
“Long live DRE, die DRE.
DRE may be dying as a screening test, but it is far from dead.
The latest evidence supports removing DRE from routine screening in asymptomatic men, yet it still retains an important role in clinical staging until imaging fully replaces it.”
Miloš Grujić — Radiation Oncologist; Head of Department; ESO College Co-chair; PhD Candidate; Prostate Cancer Specialist | ESO Ambassador | Lecturer at IPSM | Researcher & Oncology Advocate | Serbia
“I am pleased to share our latest publication in Cancers.
‘Selected Blood-Accessible Biomarkers in Prostate Cancer Radiotherapy: A PRISMA-ScR Timing-Window Framework Beyond PSA.’
In this scoping review, we explored the current clinical evidence on blood-accessible biomarkers in prostate cancer radiotherapy and highlighted an often-overlooked aspect: the timing of blood sampling.
Our findings suggest that different biomarkers follow different biological kinetics, meaning that a single sampling schedule may not be appropriate for all biomarkers.
We hope this work will contribute to more standardized biomarker research and support future studies in precision radiation oncology.
I would like to sincerely thank all my co-authors for their collaboration and valuable contributions.”
Brigida Anna Maiorano — GU Oncology at IRCCS San Raffaele Hospital and Scientific Institute | Italy
“EV-304 has added another important piece to the rapidly evolving landscape of perioperative treatment for patients with muscle-invasive bladder cancer.
How should we navigate among these increasingly effective options?
The timing could not have been more fitting: our network meta-analysis has just been published in ESMO Open, on the very same day as the official publication of one of the pivotal trials included in our analysis.
A huge thank you to all the co-authors who contributed to this collaborative effort.”
Neal Shore — Medical Director, CPI – Carolina Urologic Research Center; Director, START GU Oncology Center of Excellence | United States
“How enzalutamide affects sex life and how taking a break from treatment affects quality of life: a plain language summary of results from the EMBARK study in people with hormone-sensitive prostate cancer and high-risk biochemical recurrence.”
Nabil Ismaili — Director of Medical Oncology and Radiotherapy Department, PES, UM6SS, HUICK, HUIM6 and Mohammed VI University of Sciences and Health | Morocco
“Thrilled to share that our editorial, ‘Emergence of HER2 as a Key Biomarker and Therapeutic Target in Advanced Urothelial Carcinoma,’ was published in the World Journal of Clinical Oncology on July 24, 2026.
This paper highlights the critical findings by Huang and He on HER2 overexpression in upper tract urothelial carcinoma and contextualizes them within the paradigm-shifting results of the phase 3 RC48-C016 trial, now published in The New England Journal of Medicine.
Key takeaway: the combination of disitamab vedotin, an anti-HER2 antibody-drug conjugate, plus toripalimab, an anti-PD-1 antibody, has demonstrated:
• Median PFS: 13.1 vs 6.5 months; HR 0.36
• Median OS: 31.5 vs 16.9 months; HR 0.54
• ORR: 76.1% vs 50.2%
• Favorable safety profile
With nearly 50% of upper tract urothelial carcinoma tumors expressing HER2, a substantial subset of patients may now benefit from this biomarker-driven therapy.
The era of precision oncology in urothelial carcinoma has truly arrived.
Grateful for the opportunity to contribute to this rapidly evolving field.”
Antonio Maldonado — Head of Department of Nuclear Medicine, Molecular Imaging PET-CT, and Radiometabolic Theragnostics at Hospital Universitario Quirónsalud Pozuelo and Hospital La Luz, Grupo Hospitalario Quirónsalud | Spain
“Phase 1 ProstACT SELECT trial data, published in Cancers, supported the use of ⁶⁸Ga-PSMA-11 PET imaging to identify patients with metastatic castration-resistant prostate cancer who may be suitable for treatment with lutetium-177 rosopatamab tetraxetan.
The study found a correlation between SPECT/CT imaging and PSMA-PET imaging in tumor targeting.”
Jeff Legos — Chief Oncology Officer at Pfizer | United States
“I’m pleased to share that the FDA has granted Priority Review for Pfizer’s supplemental New Drug Application for an investigational PARP inhibitor plus ARPI combination regimen for men with HRR gene-mutated metastatic castration-sensitive prostate cancer.
For men living with metastatic prostate cancer whose disease is still responsive to hormone therapy, intervening during this earlier stage represents an opportunity to delay progression before the disease becomes more difficult to manage.
If approved, this combination may provide an important new treatment option for patients with HRR gene-mutated mCSPC and further reinforce the importance of biomarker-driven treatment strategies in prostate cancer.
Congratulations to the Pfizer team for reaching this milestone, and thank you for your ongoing commitment to advancing innovative treatment options for men with prostate cancer.”
Fabiano Flauto — Medical Oncologist at Azienda Sanitaria Locale Napoli 3 Sud | Italy
“Happy to share our latest publication in The Oncologist: ‘The impact of relative dose intensity on pathological complete response in neoadjuvant chemotherapy of muscle-invasive urothelial cancer: a multicenter retrospective study.’
In this multicenter study, we investigated the impact of maintaining an adequate relative dose intensity of cisplatin-based neoadjuvant chemotherapy on pathological complete response and survival outcomes in patients with muscle-invasive urothelial carcinoma.
Our findings reinforce the importance of treatment intensity as a potentially modifiable factor associated with improved oncological outcomes.
I would like to express my sincere gratitude to my colleague and co-first author Giuseppe Neola and to Luigi Formisano for his invaluable guidance and mentorship.
Finally, I would like to thank all the co-authors and participating centers for contributing patient data, their expertise, and their commitment to the preparation of this manuscript.
This work would not have been possible without such a collaborative effort.”
Liang Cheng, MD — Vice Chair, Professor of Pathology & Surgery (Urology), Director of Anatomic Pathology & Molecular Pathology, Warren Alpert Medical School of Brown University; Associate Director, Legorreta Cancer Center | United States
“What is the role of mesenchymal stem cells in bladder cancer progression and the evolving landscape of targeted therapy and precision oncology?
Delighted to share this article published this month in the International Journal of Biological Sciences.
In this study, Dr. Zhiping Wang and colleagues identify mesenchymal stem cell-derived TIMP1 as a critical driver of bladder cancer progression.
Using clinical specimens, single-cell transcriptomics, organoid models, and patient-derived xenografts, the authors demonstrate that increased mesenchymal stem cell infiltration and elevated TIMP1 levels are associated with advanced stage, lymphovascular invasion, and poorer clinical outcomes.
Mechanistically, mesenchymal stem cell-derived TIMP1 activates the cMet–RAP1 signaling pathway, promoting mitochondrial quality control through the formation of vesicles derived from the inner mitochondrial membrane, thereby enhancing tumor growth.
Importantly, pharmacologic inhibition of TIMP1 signaling suppressed tumor progression in preclinical models without significant toxicity, highlighting the MSC–TIMP1–RAP1 axis as a promising therapeutic target and opening new avenues for precision oncology in bladder cancer.
Great honor to be part of this important study.”
Katy Beckermann — GU Medical oncologist, clinical trials and drug development, RCC, Bladder, and Prostate Cancer | United States
“Can dual-energy CT predict bladder tumor grade before resection?
This model reached an AUC of 0.89 for distinguishing high-grade versus low-grade non-muscle-invasive bladder cancer.
Key points:
• Nomogram AUC: 0.89
• Peritumoral radiomics added signal
• 193 patients, single-center study
• External validation is needed
These findings suggest opportunities for earlier personalized care and noninvasive assessment, which could help save time.”
Find out 10 Must-Read Posts in GU Oncology from the third week of July on OncoDaily.