The second week of June brought together important updates across GU Oncology, with 10 expert posts highlighting new clinical data, regulatory milestones, biomarker-driven strategies, imaging advances, pathology consensus work, and evolving treatment approaches in bladder, prostate, kidney, and testicular cancers.
This week’s selection includes updates on intravesical recombinant BCG plus perioperative chemo-immunotherapy in muscle-invasive bladder cancer, PSMA-PET added to MRI in the prostate cancer diagnostic pathway, real-world evidence comparing apalutamide and enzalutamide in metastatic castration-sensitive prostate cancer, ddMVAC-based chemoimmunotherapy in localized MIBC, and the FDA approval of belzutifan plus pembrolizumab in high-risk clear cell renal cell carcinoma.
The posts also cover multimodal artificial intelligence for predicting abiraterone benefit in high-risk localized prostate cancer, the role of local treatment of the primary tumour in metastatic hormone-sensitive prostate cancer, clinical validation of EAU definitions of BCG failure in non–muscle-invasive bladder cancer, ISUP consensus publications on genitourinary cancer precursor lesions, and evolving strategies to reduce long-term toxicity in testicular cancer care.
Together, these posts reflect the breadth of current GU oncology research and practice, from precision imaging and perioperative therapy to molecular stratification, pathology standards, treatment personalization, and survivorship-focused care.
María Natalia Gandur Quiroga — GU Medical Oncologist; Head of GU Tumours at Ángel H. Roffo Oncology Institute, University of Buenos Aires | Argentina
“ASCO26 SAKK 06/19
Intravesical recombinant BCG + perioperative chemo-immunotherapy in MIBC
Published in Journal of Clinical Oncology:
SAKK 06/19 is one of the most interesting MIBC studies from ASCO26 because it asks a biologically elegant question:
Can local immune priming with intravesical recombinant BCG enhance systemic perioperative chemo-immunotherapy?
The trial evaluated intravesical rBCG combined with atezolizumab, cisplatin and gemcitabine in operable muscle-invasive bladder cancer.
Key findings:
• pCR / ypT0N0: 68%
• Pathologic downstaging ≤ypT1 ypN0: 83%
• The regimen was feasible and tolerable
• Treatment delivery was strong
• The signal compared favorably with prior SAKK 06/17 data
But this needs careful interpretation.
SAKK 06/19 is phase II and single-arm.
The comparison with SAKK 06/17 is informative but not randomized, and the trials used different checkpoint inhibitors.
Follow-up remains short, the sample size is small, and several patients did not undergo cystectomy.
My take:
SAKK 06/19 is not a new standard.
It is a highly relevant signal that local immune priming may become an important component of future MIBC perioperative strategies.
The next question is whether this concept can be validated in randomized trials, and whether it can help us build safer, response-adapted, MDT-based pathways without overinterpreting early pCR data.”
Read about SAKK 06/19 on OncoDaily.
Michael Hofman — Professor and Nuclear Medicine Physician at Peter MacCallum Cancer Centre and the University of Melbourne | Australia
“Thrilled to share PRIMARY2 Trial Results. This is the first randomised trial to show that adding [⁶⁸Ga]Ga-PSMA-11 PET-CT to MRI can safely halve the number of men needing a prostate biopsy.
Hot off the press in The Lancet Oncology
In 660 men across Australian sites with PI-RADS 2-3 but high clinical risk, PSMA-PET:
Avoided biopsy in nearly half (49%)
Was non-inferior for detecting clinically significant cancer (12% vs 16%)
Halved the overdiagnosis of insignificant cancer (32% to 14%)
Fewer biopsies, less overdiagnosis, whilst not missing clinically significant prostate cancer: a real step forward for the diagnostic pathway.”
Lingling Tian — Editor, Therapeutic Advances in Medical Oncology; Co-Editor, Clinical Medicine Insights: Oncology | China
“New Article Published
Real-world evidence plays a critical role in understanding how treatments perform outside clinical trials. This new study evaluates the comparative effectiveness of apalutamide versus enzalutamide for prostate-specific antigen (PSA) response in patients with metastatic castration-sensitive prostate cancer (mCSPC).
The findings provide valuable insights to help inform treatment selection and optimize patient outcomes in everyday clinical practice.”
Diego Lopez Macias, MD — Medical Oncologist at the Genitourinary Tumors Clinic, National Cancer Institute of Mexico | Mexico
“Can we improve outcomes in muscle-invasive bladder cancer (MIBC) by optimizing the chemotherapy backbone for perioperative immunotherapy?
The phase II NEMIO trial evaluated neoadjuvant dose-dense MVAC (ddMVAC) plus durvalumab, with or without tremelimumab, in cisplatin-eligible patients with localized MIBC undergoing radical cystectomy.
The study demonstrated that combining ddMVAC + durvalumab achieved an impressive pathological complete response (pCR) rate while maintaining surgical feasibility and encouraging early survival outcomes. Importantly, the addition of tremelimumab increased toxicity without improving efficacy.
These findings raise an important question: could ddMVAC represent a more immunogenic chemotherapy backbone than gemcitabine-cisplatin when combined with immune checkpoint blockade in the perioperative setting?
As the treatment landscape for MIBC rapidly evolves following NIAGARA and emerging perioperative strategies, the NEMIO results provide additional support for further investigation of ddMVAC-based chemoimmunotherapy approaches and response-adapted bladder preservation strategies.
Key statistics from NEMIO:
• Overall pCR rate: 47.8%
• pCR with ddMVAC + durvalumab: 49.1%
• pCR with ddMVAC + durvalumab + tremelimumab: 46.6%
• PD-L1–high tumors achieved a pCR rate of 69.6%
• 2-year Event-Free Survival: 74.8%–77.2%
• 2-year Overall Survival: 84.9%–87.9%
• Grade ≥3 treatment-related adverse events:
31.7% with ddMVAC + durvalumab
52.5% with ddMVAC + durvalumab + tremelimumab
The take-home message: ddMVAC + durvalumab appears highly active in the neoadjuvant setting, whereas adding CTLA-4 blockade increased toxicity without a clear efficacy signal.”
Read about NEMIO Updates on OncoDaily.
Katy Beckermann — Medical Director, GU Clinical Research at Tennessee Oncology; Chair, OneOncology GU Disease Group | United States
“The adjuvant standard in high-risk kidney cancer just changed.
On June 12, 2026, the FDA approved belzutifan plus pembrolizumab for adults with clear cell RCC at intermediate-high or high risk of recurrence after nephrectomy, or after resection of metastatic disease. It’s the first regimen to improve DFS compared to adjuvant pembrolizumab monotherapy in a head-to-head trial.
LITESPARK-022, phase 3, double-blind, 1,841 patients randomized 1:1
Clear cell RCC, intermediate-high or high recurrence risk post-nephrectomy, or resected metastases with no evidence of disease
DFS HR 0.72 (95% CI 0.59-0.87), p=0.0003, a 28% reduction in recurrence or death
24-month DFS 80.7% vs 73.7%; median DFS not reached, median follow-up 28.4 months
More anemia, hypoxia, and liver enzyme elevation with belzutifan
OS data immature
Why this matters for your practice: A real DFS gain that supports a new adjuvant option for the highest-risk patients, but the OS readout is still pending and the added toxicity is not trivial. Patient selection and informed decision making.
How are you weighing the DFS benefit against added toxicity for your intermediate-high risk patients while OS matures?”
Salah-Eddin Al-Batran, MD — Director, Institute of Clinical Research, UCT-University Cancer Center Frankfurt | Germany
“I enjoyed reading this article just published in Annals of Oncology. It beautifully demonstrates how artificial intelligence can revolutionize medicine.
Using data from the randomized STAMPEDE trials, Parker et al. implemented a validated multimodal artificial intelligence (MMAI) model combining digital pathology images with clinical parameters to predict the benefit of treatment intensification with abiraterone in high-risk localized prostate cancer.
The findings are impressive:
Patients classified by AI as very high risk (75th percentile) showed a strong benefit from adding abiraterone:
• HR for metastasis-free survival: 0.47
• 5-year MFS improved from 62% to 81%
In contrast, patients classified as standard high risk showed only limited additional benefit:
• HR: 0.83
• 5-year MFS: 82% vs 84%”
Read more about STAMPEDE Updates on OncoDaily.
Giuseppe Procopio — Chief of Genitourinary Oncology; Director, Prostate Cancer Program; FICOG and Meet-URO President | Italy
“Our latest expert opinion in Expert Review of Anticancer Therapy: “Local treatment of the primary tumour in mHSPC in the ARPI era: incremental value or overtreatment?”
The treatment landscape of mHSPC has dramatically evolved with the introduction of ARPIs, leading to significant improvements in patient outcomes.
In this context, an important question emerges: does local treatment of the primary tumour still provide meaningful additional benefit, or are we approaching a risk of overtreatment?
In our review, we discuss:
• The evidence supporting prostate radiotherapy in low-volume mHSPC from the ADT era
• The impact of modern systemic intensification on the value of local therapies
• Insights from PEACE-1 and other key studies
• The potential role of surgery in selected patients
• Ongoing trials that will help define future treatment strategies, including SWOG S1802, SIMCAP and APPROACH
Our perspective is that local treatment should increasingly be considered within a personalized, multidisciplinary framework. Beyond overall survival, its value may lie in improving local control, delaying progression, and preventing genitourinary complications in carefully selected patients.”
Enrique Grande — Medical Oncology Department Director at Quirónsalud Madrid | Spain
“First clinical validation of the EAU definitions of BCG failure in NMIBC (n=776).
BCG-refractory disease showed the highest progression rates: 46% at 5 years for HG recurrence at 6 months during maintenance. Early BCG-unresponsive recurrences conveyed similar progression risk to BCG-refractory disease (35% at 5 yr), supporting their inclusion in this category.
Prognostically informative definitions that can support clinical decision-making.”
Liang Cheng — Vice Chair; Professor of Pathology and Surgery (Urology); Director of Anatomic Pathology and Molecular Pathology at Warren Alpert Medical School of Brown University; Associate Director, Legorreta Cancer Center | United States
“ISUP Florence Consensus Conference Publications on Genitourinary Cancer Precursor Lesions Released! Congratulations to the ISUP Consensus Panel and contributing authors.
If interested, please also join ISUP Multidisciplinary Expert Consultation Conference on Precision Biomarker Testing in Genitourinary Malignancies, which will take place on Saturday, September 12, 2026, from 7:30 AM to 1:30 PM in Stockholm, Sweden. Registration is now open.”
Gagan Prakash — Chief, Division of Urologic Oncology, Tata Memorial Centre | India
“Testicular cancer has excellent survival rates, but conventional therapies often leave young men with long-term toxicities. This review highlights how surgical refinements in RPLND, novel biomarkers like microRNA-371, and de-escalated surveillance strategies (MRI, reduced imaging, telehealth) are reshaping care.”
Read more about 15 Posts Not To Miss From ASCO 2026: GU Edition on OncoDaily.