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| ZIRCON-X: How CAIX PET Imaging Influences Surgery, Biopsy, and Treatment Strategy in Indeterminate Renal Masses |
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Brian Shuch, MD
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| Brian Shuch speaks with Pedro Barata about a study evaluating how girentuximab PET imaging impacts management of renal masses. Using data from the ZIRCON trial, four multidisciplinary teams reviewed approximately 300 cases before and after receiving PET results targeting carbonic anhydrase IX.
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Highlights from the 2025 Society of Urologic Oncology Annual Meeting |
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| Five-Year Follow-Up Results from the Phase 3 KEYNOTE-564 Study of Adjuvant Pembrolizumab for the Treatment of Clear Cell Renal Cell Carcinoma
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| Naomi Haas, MD
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| Five-year follow-up data from the phase 3 KEYNOTE-564 trial confirmed that adjuvant pembrolizumab provides sustained, long-term benefits for high-risk clear cell RCC after nephrectomy, significantly improving disease-free and overall survival compared with placebo. Survival advantages were consistent across all risk groups, including the highest-risk M1 NED cohort, with durable reductions in recurrence and distant metastases.
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| ZIRCON-X: Impact of 89Zr-Girentuximab PET/CT Versus Conventional Imaging on Clinical Decision-Making in Patients with Indeterminate Renal Masses |
| Brian Shuch, MD |
| Brian Shuch presented ZIRCON-X, a post-hoc analysis showing that 89Zr-girentuximab PET/CT significantly improves clinical decision-making for patients with indeterminate renal masses compared with standard CT/MRI. Nearly 50% of patients would have had a management change—over one-third major—including treatment escalation/de-escalation, avoiding biopsy, or altering surgical plans. |
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| Role of ctDNA Testing in BCG-Exposed Non-Muscle-Invasive Bladder Cancer: A Real-World Analysis
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| Can Aydogdu, MD
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| This real-world SUO 2025 analysis evaluated ctDNA surveillance in 17 BCG-exposed NMIBC patients and found ctDNA positivity in 47%, particularly among those with clinically advanced or ultimately upstaged disease. All ctDNA-positive patients who underwent radical cystectomy were pathologically upstaged, while all ctDNA-negative patients had pT0N0 outcomes.
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| LITESPARK-004: 5-Year Follow-Up of the Hypoxia-Inducible Factor-2α (HIF-2α) Inhibitor Belzutifan in Von Hippel-Lindau (VHL) Disease–Associated Neoplasms
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| W. Marston Linehan, MD
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| With over five years of follow-up, the phase II LITESPARK-004 trial shows that belzutifan continues to deliver durable, high response rates across VHL-associated tumors, including RCC (70% ORR), CNS hemangioblastomas (50%), and pNETs (90%). Most responses persisted beyond four years, and belzutifan substantially reduced the need for additional VHL-related surgeries.
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| Neo-SAbR: A Phase II Trial of Neoadjuvant Stereotactic Ablative Radiotherapy for Caval Thrombus in Newly Diagnosed Renal Cell Carcinoma |
| Lin Lin, MD |
| The phase II Neo-SAbR trial tested neoadjuvant stereotactic ablative radiotherapy before radical nephrectomy and IVC thrombectomy in RCC patients with Mayo II–IV tumor thrombus and showed the approach is safe and feasible. One-year relapse-free survival was 71%, exceeding historical surgery-alone outcomes, with no radiation-related grade 4+ toxicities and low perioperative morbidity. |
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| RECURxNCE-BCa – An Artificial Intelligence-Based Tool to Predict Recurrence in NMIBC and Comparison with Current Risk Stratification Tools for Intermediate-Risk Disease |
| Jethro Kwong, MD, MSc |
| The RECURxNCE-BCa model is a new AI-based recurrence predictor for NMIBC that was trained and validated on the largest multinational dataset to date and consistently outperformed established tools like EORTC, CUETO, and the EAU systems. It demonstrated superior discrimination, calibration, and clinical utility across nearly all patient subgroups, including high-risk and intermediate-risk disease. |
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