|
|
|
|
|
|
|
Highlights from the 2026 American Urologic Association (AUA) Annual Meeting
|
|
|
|
| Long-Term Follow-Up Results of aMVAC Arm of ECOG-ACRIN EA8141: a Prospective Phase II Trial of Neoadjuvant Systemic Chemotherapy Followed by Extirpative Surgery for Patients with High-Grade Upper Tract Urothelial Carcinoma
|
| Ali Zahalka, MD
|
| Ali Zahalka's AUA 2026 long-term follow-up from EA8141 confirmed that neoadjuvant aMVAC for high-grade UTUC produces durable benefit, with 5-year recurrence-free survival of 68.4% and overall survival of 82.6%. Patients who achieved pathologic response had particularly favorable outcomes, maintaining approximately 80% recurrence-free survival at five years, supporting neoadjuvant cisplatin-based chemotherapy as standard of care in eligible patients.
|
|
|
|
|
|
| The ENLIGHTED Phase 3 Trial: Advancing Treatment of Low-Grade Upper Tract Urothelial Carcinoma (LG UTUC) with Padeliporfin Vascular-Targeted Photodynamic Therapy (VTP)
|
| Vitaly Margulis, MD
|
| Vitaly Margulis's AUA 2026 presentation on the ENLIGHTED phase 3 trial showed that padeliporfin vascular-targeted photodynamic therapy produced an 88% overall response rate and 70% complete response rate in low-grade UTUC, with durable responses extending beyond 23.9 months median duration of response. The therapy was well tolerated, with most adverse events being low-grade and transient, and only two patients experiencing grade 3 treatment-related serious adverse events that resolved quickly, supporting padeliporfin VTP as a promising kidney-sparing option for low-grade UTUC.
|
|
|
|
|
|
| Evaluating Deep Early Tumor Shrinkage in Metastatic Upper Tract Urothelial Carcinoma Treated with Enfortumab Vedotin plus Pembrolizumab
|
| Marie Semmler, MD
|
| Marie Semmler's AUA 2026 study found that deep early tumor shrinkage—defined as ≥50% reduction in tumor burden at first follow-up imaging—occurred in 27% of metastatic UTUC patients treated with first-line EV+P and was associated with more durable and sustained responses. The analysis showed substantial site-specific heterogeneity in response, with lung and "other" metastases shrinking most and primary upper tract lesions showing modest reduction, suggesting that deep early tumor shrinkage may serve as a useful early prognostic marker to complement standard RECIST assessment in guiding treatment decisions for metastatic UTUC.
|
|
|
|
|
|
| Machine Learning–Based Prediction of Progression to Radical Nephroureterectomy After Endoscopic Management of Upper Tract Urothelial Carcinoma
|
| Sri Saran Manivasagam, MD
|
| Sri Saran Manivasagam's machine learning study built models from 437 patients that predicted two-year progression to nephroureterectomy after endoscopic UTUC management, with the gradient boosting model achieving an AUC of 0.882 and 100% specificity. Key predictive factors included Charlson Comorbidity Index, age, biopsy grade, tumor size >2 cm, and presence of local symptoms, suggesting these tools could improve counseling and help identify patients who might benefit from upfront radical surgery rather than kidney-sparing approaches.
|
|
|
|
|
|
|
|
|
|
|
| Ureteral Stricture and Subsequent Intervention After Mitomycin Treatment for Upper Tract Urothelial Carcinoma: A Retrospective TriNetX Cohort Study
|
| Patrick Mershon, MD
|
| Patrick Mershon presented the TriNetX study of 750 patients treated with mitomycin for UTUC found that ureteral strictures and related interventions increased progressively over time, with 45% experiencing hydronephrosis and nearly half requiring ureteral stent placement by five years. These real-world data closely parallel the OLYMPUS trial findings and emphasize the need to counsel patients about the substantial long-term burden of upper tract obstruction and the likelihood of repeated interventions after mitomycin treatment.
|
|
|
|
|
|
| Paradigm 1 - A Multi-Center Phase 1 Study Evaluating the Safety and Clinical Effect of A Novel Microbial Immunotherapeutic (ZH9) in Patients with Relapsed NMIBC – A First Interim Review
|
| Michael Oefelein, MD, FACS
|
| Michael Oefelein's AUA 2026 presentation on the PARADIGM 1 phase 1 study showed that ZH9, a live attenuated Salmonella Typhi-based microbial immunotherapy, was well tolerated in 22 relapsed NMIBC patients, with only mild treatment-emergent adverse events and no dose-limiting toxicities. Interim data from 11 patients who completed the study demonstrated 91% freedom from relapse at 12 months despite a heavily pre-treated population, and ZH9 triggered a transient local pro-inflammatory Th1 immune response without systemic involvement, supporting quarterly dosing as a promising next-generation intravesical immunotherapy.
|
|
|
|
|
|
| A Fully Automated Artificial Intelligence System for Urine Cytology: Results from a Large Multicenter External Validation
|
| Masatomo Kaneko, MD
|
| Masatomo Kaneko's AUA 2026 presentation validated a fully automated AI system for urine cytology across 811 slides from four external institutions, achieving an AUC of 0.79 for detecting high-grade urothelial cancer with accuracy and sensitivity comparable to board-certified pathologists. The AI system demonstrated robust and consistent performance across institutions and has the potential to automate pre-screening and streamline the urine cytology workflow to assist uropathologists.
|
|
|
|
|
|
| PATAPSCO: Durvalumab in Combination with BCG for BCG-Naïve, High-Risk NMIBC: Primary Results from a US-Based, Phase IIIb, Open-Label, Single-Arm, Multicenter Study
|
| Mark Tyson, II, MD, MPH
|
| Mark Tyson's AUA 2026 presentation of the PATAPSCO phase IIIb study showed that durvalumab plus BCG induction and maintenance therapy was safe and well tolerated in 99 U.S. patients with BCG-naïve high-risk NMIBC, with only 12.1% experiencing grade 3 or 4 treatment-related adverse events within six months. The safety profile was consistent with the individual therapies, immune-related adverse events were mostly low-grade, and no new safety signals were identified, supporting the combination as a feasible treatment approach in this population.
|
|
|
|
|
|
|
|
|
|
|
