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Highlights from the 2025 American Society of Clinical Oncology Genitourinary Cancers Symposium |
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| Creative Innovation: Driving Science to Improve Patient-Centered Care |
| William L. Dahut, MD |
| William Dahut’s ASCO GU 2025 keynote highlighted the American Cancer Society’s (ACS) efforts to advance patient-centered cancer care through research funding, clinical trial accessibility, and AI-driven innovations. ACS has committed over $517 million in research grants, with initiatives like EDS Accelerator and Catalyst Grants supporting translational research and health equity. He also emphasized AI’s growing role in cancer detection, treatment optimization, and data analysis, while addressing barriers to clinical adoption and the need for trust in AI systems. |
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| Management of Biochemical Recurrence after Radiation Therapy for Localized Prostate Cancer: Reirradiation, Brachytherapy and SBRT |
| Juanita Crook, MD, FRCPC |
| Juanita Crook discussed salvage treatment options for biochemical recurrence after radiation therapy in localized prostate cancer, focusing on brachytherapy, high-dose-rate (HDR) brachytherapy, and stereotactic body radiation therapy (SBRT). She highlighted the benefits and risks of whole-gland and focal brachytherapy, noting comparable efficacy but varying toxicity profiles between low-dose-rate (LDR) and HDR approaches. |
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| Ablative Therapies for Radio-Recurrent Disease |
| Thomas Polascik, MD |
| Thomas Polascik’s presentation highlighted the rising incidence of radio-recurrent prostate cancer and the role of salvage ablative therapies. Compared to salvage surgery, salvage focal ablation offers better continence and erectile function preservation, with lower morbidity. While focal and whole-gland ablation have similar long-term survival, future advancements in cancer-targeted therapies and imaging are needed to optimize treatment selection. |
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| Management of Biochemical Recurrence After Radiation Therapy for Localized Prostate Cancer with Salvage Surgery |
| Ashley Ross, MD, PhD |
| Ashley Ross’s presentation on salvage prostatectomy for biochemical recurrence after radiation therapy emphasized the importance of patient selection, cancer control expectations, and surgical challenges. While the procedure offers a 5-year biochemical recurrence-free survival of ~50%, metastasis-free survival of ~80%, and cancer-specific survival of ~95%, morbidity remains high. Incontinence and erectile dysfunction are common, with major complications in ~15% of cases. |
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| The Impact of Salvage Therapies: Functional Outcomes and Quality of Life |
| Alicia Morgans, MD, MPH, FASCO |
| Alicia Morgans’ presentation emphasized that quality of life (QOL) must be a standard consideration in treatment decisions for biochemical recurrence after radiation therapy. She highlighted the limitations of current patient-reported outcome measures and the need for better tools to capture meaningful patient experiences. While trials like PRESTO and PR-7 suggest minimal QOL differences between intermittent and continuous systemic therapy, questions remain about whether we are measuring the right factors. |
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| World-Wide Oligometastatic Prostate Cancer Meta-Analysis Leveraging Individual Patient Data from Randomized Trials (WOLVERINE): An Analysis from the X-MET Collaboration |
| Chad Tang, MD |
| Dr. Chad Tang presented the WOLVERINE meta-analysis, leveraging individual patient data from five randomized trials to evaluate metastasis-directed therapy (MDT) in oligometastatic prostate cancer. The pooled analysis demonstrated significant benefits of MDT across multiple endpoints, including improved progression-free survival, radiographic PFS, and castration resistance-free survival, with a trend toward improved overall survival. These benefits were consistent across subgroups, reinforcing MDT’s role in omPC management. |
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| Impact of Testosterone Recovery After Androgen Deprivation Therapy on Overall Survival in Patients with High-Risk Prostate Cancer: Long-Term Data from a Phase III Trial |
| Abdenour Nabid, MD |
| Abdenour Nabid presented long-term data from a phase III trial at ASCO GU 2025, examining the impact of testosterone recovery after androgen deprivation therapy (ADT) in high-risk prostate cancer patients. Among 515 evaluable patients from the PCS 4 trial, those who recovered testosterone had significantly improved overall survival, with recovery more common after 18 months of ADT than 36 months. |
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| Gut Health and Prostate Cancer: The Influence of a Specific Phytochemical-Rich Food Capsule plus or Minus a Probiotic/prebiotic Blend on Symptoms and progression—A Randomised, Double-Blind Placebo-Controlled Trial |
| Robert Thomas, PhD |
| Robert Thomas presented results from a randomized, double-blind placebo-controlled trial at ASCO GU 2025, investigating the impact of a phytochemical-rich food supplement with or without a probiotic/prebiotic blend on prostate cancer progression. Among 212 men with rising PSA levels, those taking the supplement alone saw a PSA rise reduction of 13.4%, while those receiving the supplement plus probiotics experienced a 41.7% PSA decrease. |
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| A High Omega-3, Low Omega-6 Diet with Fish Oil for Men with Prostate Cancer on Active Surveillance: The CAPFISH-3 Randomized Clinical Trial |
| William Aronson, MD |
| Dr. William Aronson presented results from the CAPFISH-3 trial at ASCO GU 2025, which evaluated the impact of a high omega-3, low omega-6 diet combined with fish oil supplementation on prostate cancer progression in men on active surveillance. Over one year, the intervention group showed a significant 15% decrease in the Ki-67 index, a biomarker for cancer progression, compared to a 24% increase in the control group. |
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| Transdermal Oestradiol Patches as Androgen Deprivation Therapy: Efficacy and Safety of Combining with Androgen Receptor Pathway Inhibitors in Metastatic (M1) Prostate cancer—Randomised Comparison from the STAMPEDE Trial Platform |
| Nicholas James, MBBS, PhD |
| Nicholas James presented findings from the STAMPEDE trial at ASCO GU 2025, comparing transdermal estradiol patches combined with androgen receptor pathway inhibitors (ARPIs) to the standard luteinising hormone-releasing hormone analogs (LHRHa) with ARPIs in metastatic prostate cancer. The study found that both treatments resulted in a similar 61% of patients achieving a PSA nadir of ≤0.2 ng/mL, with no new safety concerns. |
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| Metastases-Directed Therapy in Addition to Standard Systemic Therapy in Oligometastatic Castration Resistant Prostate Cancer: A Randomized Phase II Trial (GROUQ-PCS 9) |
| Tamim Niazi, MD |
| Tamim Niazi presented results from the GROUQ-PCS 9 trial at ASCO GU 2025, which assessed the addition of metastasis-directed therapy to standard enzalutamide and ADT in oligometastatic castration-resistant prostate cancer. The addition of SBRT significantly improved radiological progression-free survival by 52%, delaying biochemical progression and time to subsequent therapy, with a 2.3-year improvement in rPFS. |
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| Mevrometostat (PF-06821497), an EZH2 Inhibitor, in Combination with Enzalutamide in Patients with mCRPC: A Randomized Dose-Expansion Study |
| Michael Schweizer, MD |
| Michael Schweizer presented results from the randomized dose-expansion study evaluating the combination of mevrometostat and enzalutamide in metastatic castration-resistant prostate cancer patients at ASCO GU 2025. The combination demonstrated a 49% relative reduction in the rate of progression or death, improving median radiological progression-free survival by approximately 8 months. It also showed superior objective response rates and PSA50 response rates. |
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| EvoPAR-Prostate01: Phase III, Double-Blind, Placebo-Controlled, 2-Cohort, Randomized Study of Saruparib in Combination with Androgen Receptor Pathway Inhibitors in Patients with mHSPC with and Without Homologous Recombination Repair Mutation |
| Arun Azad, MBBS, PhD, FRACP |
| Arun Azad presented EvoPAR-Prostate01, a phase III trial evaluating saruparib, a selective PARP inhibitor, in combination with androgen receptor pathway inhibitors for metastatic hormone-sensitive prostate cancer. This double-blind, placebo-controlled study includes two cohorts: one with and one without homologous recombination repair gene mutations. The primary endpoint is radiographic progression-free survival, with overall survival as a secondary endpoint. |
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| Mevrometostat (PF-06821497) in Combination With Enzalutamide for Androgen Receptor Pathway Inhibitor (ARPI)-Naïve Patients With mCRPC: The Phase 3, Randomized MEVPRO-2 Trial |
| Michael T. Schweizer, MD |
| Michael Schweizer presented the MEVPRO-2 phase 3 trial, exploring the combination of Mevrometostat, an EZH2 inhibitor, with enzalutamide in androgen receptor pathway inhibitor (ARPI)-naïve patients with metastatic castration-resistant prostate cancer. The trial aims to evaluate whether Mevrometostat can delay or prevent antiandrogen resistance, thus extending the clinical benefits of enzalutamide. This global, randomized, double-blind, placebo-controlled study will enroll 900 patients, with the primary endpoint being radiographic progression-free survival. |
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| CONVERGE-01: Dosimetry, Randomized Dose Optimization, Dose Escalation, and Efficacy of Ac-225 Rosopatamab Tetraxetan in Participants with PSMA-Positive CRPC |
| Michael J. Morris, MD |
| Michael Morris presented the CONVERGE-01 trial, focusing on Ac-225 rosopatamab tetraxetan, a high-affinity radioantibody targeting PSMA for treating PSMA-positive castration-resistant prostate cancer (CRPC). The trial explores the dosimetry, dose optimization, and efficacy of this agent, which has demonstrated promising results in earlier trials. Ac-225 offers improved precision and potency as a radionuclide for radiopharmaceutical therapy compared to small-molecule PSMA-targeting agents, with reduced risk of toxicity, especially in salivary glands and kidneys. |
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| ProstACT GLOBAL: A Phase 3 Study of 177Lu-Rosopatamab (TLX591) with and Without the Best Standard of Care for Patients with PSMA Expressing mCRPC Progressing Despite Prior Treatment with a Novel Androgen Axis Drug |
| Oliver Sartor, MD |
| Oliver Sartor presented the ProstACT GLOBAL trial, a phase 3 study evaluating the efficacy of 177Lu-rosopatamab (TLX591), a PSMA-targeted radioimmunotherapy, in patients with metastatic castration-resistant prostate cancer (mCRPC) progressing despite prior androgen axis drug therapy. This multinational, multicenter trial consists of two parts. Part 1 (n=30) involves dosimetry and safety lead-in with 177Lu-rosopatamab plus standard of care (abiraterone, enzalutamide, or docetaxel). |
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| Final Overall Survival with Talazoparib + Enzalutamide as First-line Treatment in Patients with HRR-deficient mCRPC in the Phase 3 TALAPRO-2 Trial |
| Karim Fizazi, MD |
| Karim Fizazi presented the final overall survival results from the phase 3 TALAPRO-2 trial, showing that talazoparib + enzalutamide significantly improved overall survival in patients with HRR-deficient mCRPC compared to placebo + enzalutamide. With a median overall survival of 45.1 months versus 31.1 months, talazoparib + enzalutamide also demonstrated strong radiographic progression-free survival, establishing it as a new standard of care for first-line treatment in this patient population. |
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| Risk Stratification Using the Decipher 22-Gene Genomic Classifier and Digital Pathology Artificial Intelligence in Nearly 10,000 Localized Prostate Cancer Patients |
| Daniel Spratt, MD |
| Daniel Spratt presented a study exploring the combination of the Decipher 22-gene genomic classifier and digital pathology artificial intelligence (AI) in nearly 10,000 localized prostate cancer patients. The results demonstrated that integrating these data sources significantly improved risk stratification for distant metastasis compared to clinical variables alone, with the combined model yielding a higher prognostic accuracy. |
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