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Highlights from The 2026 American Society of Clinical Oncology (ASCO) Annual Meeting
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| New Approaches to Curing Bladder and Kidney Cancers: Where Do We Stand Today?
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| Srikala Sridhar, MD, MSc, FRCPC
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| Srikala Sridhar discussed how the field is advancing toward cure, but the main challenge is making sure better outcomes also mean better patient-centered care. In bladder cancer, perioperative enfortumab vedotin plus pembrolizumab and bladder-sparing strategies are changing practice; in kidney cancer, adjuvant immunotherapy remains promising but still needs better selection, endpoints, and quality-of-life data.
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| Living Longer, Living Better: Can We Have It All?
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| Brian Rini, MD
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| Brian Rini discussed how GU oncology must balance cure with quality of life, noting that RAD-IO showed durvalumab plus chemoradiotherapy is feasible for MIBC but needs longer follow-up, while RAMPART supported adjuvant durvalumab in RCC but left CTLA-4 addition uncertain due to higher toxicity. He emphasized that current quality-of-life tools miss what patients value, calling for better biomarkers and patient-defined toxicity measures to personalize therapy and reduce decision regret.
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| Neoadjuvant Treatment Strategies in Renal Cell Carcinoma
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| Rana R. McKay, MD
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| Rana McKay reviewed neoadjuvant strategies in RCC, noting that while early TKI-based neoadjuvant therapy produced modest tumor shrinkage, combination immunotherapy regimens now show more encouraging pathologic response signals, though neoadjuvant RCC therapy remains investigational after the negative PROSPER phase III trial. She emphasized key lessons from melanoma that neoadjuvant plus adjuvant immunotherapy can improve event-free survival, and stressed the critical unmet need for a standardized, validated RCC-specific pathologic response framework that correlates with long-term outcomes.
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| Management in Bladder Cancer after Pathologic Complete Disease Response
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| Brendan Guercio, MD
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| Brendan Guercio discusses how pCR after neoadjuvant therapy is strongly prognostic in MIBC, but management differs by regimen: after neoadjuvant cisplatin-based chemo alone, surveillance is standard for pCR, whereas after perioperative immunotherapy “sandwich” regimens, patients should complete planned adjuvant therapy. Although ctDNA is prognostic, it's not yet validated to de-escalate treatment, so using pCR/ctDNA to omit adjuvant therapy remains investigational within trials.
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| Clinical Applications of Pathologic Biomarkers in Genitourinary Cancers
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| Cornelia Ding, MD, PhD
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| Cornelia Ding emphasized three principles for pathologic biomarkers in GU cancers: no single perfect assay, lack of standardization across labs, and the need for close clinician–pathologist collaboration to prioritize tests and optimize tissue. She reviewed MSI/dMMR, HER2, and Nectin-4.
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| Circulating Tumor DNA (ctDNA) Dynamics as Early Biomarkers of Response to Enfortumab Vedotin plus Pembrolizumab in Advanced Urothelial Carcinoma
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| Mohammad Jad Moussa, MD, MSc
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| This retrospective MD Anderson analysis of 79 aUC patients on frontline EV + pembrolizumab showed that early ctDNA dynamics strongly predict response and survival: ctDNA clearance at first on-treatment assessment was associated with an 87% objective response rate versus 55.6% with decrease and 38.4% with increase, and time-dependent modeling linked rising ctDNA to worse PFS and a trend toward worse OS.
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| Disitamab Vedotin Combined with Toripalimab and Pelvic Lymph Node Dissection for Bladder Preservation in Patients with cT2-4aN0M0 Bladder Urothelial Carcinoma and HER2 Expression ≥ 2+ After Maximal TURBT
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| Tianhang Lan, MD
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| This single-arm phase II study of disitamab vedotin plus toripalimab with maximal TURBT and pelvic lymph node dissection for HER2 ≥2+ cT2–4aN0M0 bladder urothelial carcinoma showed high early efficacy: 85.8% clinical complete response at week 12 and 90% pathologic complete response among patients undergoing TURBT + PLND, with generally manageable grade 1–2 toxicities and no grade ≥4 events. Occult nodal disease was found in one patient despite bladder pCR, underscoring PLND's potential value in bladder-sparing strategies for HER2-positive disease.
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| Final Results from a Phase II Study of Tislelizumab Combined with RT as Bladder Preserving Treatment for High-Risk NMIBC Patients with Unresponsive BCG
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| Zhiyong Li, MD
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| This phase II study showed that tislelizumab plus radiotherapy is an effective bladder-preserving option for BCG-unresponsive high-risk NMIBC, meeting its primary endpoint with a 12-month disease-free survival of 90.6% and 24-month DFS of 70.2%, while achieving a 24-month bladder-preservation rate of 93.2% and 24-month overall survival of 100%. Toxicities were manageable, with treatment-related adverse events in 84.4% and grade 3 events in 21.9% (most commonly diarrhea), and no grade 4–5 events.
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| Adjuvant Nivolumab in High-Risk Muscle-Invasive Urothelial Carcinoma: Real-World Evidence from the SOGUG-NIADY Study of the Spanish Oncology Genitourinary Group (SOGUG)
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| Aurea Molina Diaz, MD
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| The SOGUG-NIADY real-world study of 395 high-risk, PD-L1–positive muscle-invasive urothelial carcinoma patients treated with adjuvant nivolumab after radical surgery showed outcomes consistent with CheckMate-274 despite an older, less selected population: at 13 months' median follow-up, 27.3% recurred, 18-month DFS and OS were 65.6% and 78.3%, and median DFS/OS were not reached.
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| Magnitude and Timing of Clinical Benefit Associated with Pathological Complete Response in Perioperative MIBC: A Reconstructed IPD Analysis of NIAGARA Trial
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| Andrea Malgeri, MD
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| This reconstructed IPD analysis of the NIAGARA trial showed that achieving pathologic complete response in perioperative MIBC confers large, early event-free survival gains and substantial later overall survival benefits: in the durvalumab + chemo arm, pCR added 5.87 months EFS and 5.32 months OS, with time-to-benefit at 9 months for EFS and 22 months for OS; in chemo alone, gains were 5.63 months EFS and 5.89 months OS, with time-to-benefit at 9 and 20 months.
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| Bulumtatug Fuvedotin (BFv; 9MW2821) + Toripalimab in Perioperative Patients with MIBC: Results of Cohort a from a Phase 2 Study
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| Zhuowei Liu, MD, PhD
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| In Cohort A of this phase 2 study, perioperative bulumtatug fuvedotin plus toripalimab showed encouraging early efficacy in muscle-invasive bladder cancer: among 6 patients who underwent radical cystectomy, pathologic complete response was 66.7% and pathologic downstaging was 83.3%, with DFS/OS not yet mature. The regimen followed a defined sequence, and safety was consistent with prior reports with no new signals.
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